Government: Collective Responsibility

Lord Trefgarne: asked Her Majesty's Government:
	Whether the doctrine of Cabinet collective responsibility applies to Her Majesty's current Ministers.

Baroness Ashton of Upholland: My Lords, yes.

Lord Trefgarne: My Lords, in that case, may we assume that the former First Sea Lord and Chief of Naval Staff, the noble Lord, Lord West of Spithead, now agrees with the proposed cuts in the Royal Navy, against which he argued so fervently before he took up his present appointment?

Baroness Ashton of Upholland: My Lords, there is nothing wrong with anyone disagreeing or wishing to discuss issues of concern in the present roles that they occupy. It is perfectly appropriate. As the noble Lord will know well, when one is operating in a particular role, one should argue from that role and perspective. The point about collective responsibility is not that Ministers should not discuss, debate and argue from their perspectives as Ministers, as individuals and as heads of their areas of responsibility. The question is whether the decision has been made and, once made, that Ministers adhere to it.

Lord Morgan: My Lords, was not David Lloyd George, that great man, correct in 1918 when he observed that a government were like an Army: that they might have individual detachments, but the important thing was unity of command? Do this Government have such a quality?

Baroness Ashton of Upholland: My Lords, they certainly do.

Lord Howell of Guildford: My Lords, I can speak only from experience, but my memory is that the idea of being a member of the Cabinet or of the Government is that one is supposed to sing from roughly the same hymn sheet. The noble Baroness talks about disagreement, but that is not usually the right course. Although Ministers can air their views, once they have reached a decision, there should not be any disagreement. We seem to have here instances of Ministers flatly disagreeing with each other. Is that a new exemption? Is there a new rule prevailing?

Baroness Ashton of Upholland: My Lords, there is no suggestion that the reference made by the noble Lord, Lord Trefgarne, to my noble friend related to when my noble friend was a Minister. The noble Lord referred to the position when my noble friend had a different role. I have said that that is completely reasonable. Noble Lords would expect governments, in reaching decisions, to have debates, disagreements and arguments when considering what is before them. Once having reached agreement, the noble Lord is right: agreements should stand.

Lord Brookman: My Lords, where did the phrase, "Not one of us", emerge from?

Baroness Ashton of Upholland: My Lords, I hesitate to give all the historical references that the phrase might have, but noble Lords opposite may well be able to enlighten us.

Female Genital Mutilation

Baroness Rendell of Babergh: asked Her Majesty's Government:
	What progress has been made in combating the crime of female genital mutilation, and whether a reward by the Metropolitan Police of £20,000 for information leading to prosecution has assisted the Government's efforts.

Lord West of Spithead: My Lords, the Female Genital Mutilation Act 2003 makes it an offence for United Kingdom residents to be taken abroad for female genital mutilation, with a maximum penalty of 14 years' imprisonment. We have commissioned research on the prevalence of FGM and instigated awareness-raising initiatives, including the training of health professionals. The Metropolitan Police has been investigating 20 to 30 reports of suspected FGM since the reward announcement in July and is raising awareness in the capital.

Baroness Rendell of Babergh: My Lords, I thank my noble friend for his Answer and I am gratified to hear about these investigations. Is he aware that successful prosecutions have been brought in other countries? In the past year and a half, one has been brought in the United States and one has been brought in Sweden, this being the second to be brought successfully in that country. Is he also aware that according to FORWARD, whose report on FGM has just been issued, 22,000 girls under the age of 15 are at risk? That is a terrible figure given that this gross child abuse leads to permanent disablement.

Lord West of Spithead: My Lords, my noble friend raises some important points. I have to admit to not having had in-depth knowledge about this subject until last week, when I realised that I was going to have to answer the Question. Now that I have looked into it in some detail, I find it the most appalling barbarity. We take it extremely seriously. Prosecutions are difficult because of the cultural differences in these communities. It is often done to very young children, who are scared, frightened and cannot raise matters within their community. There is a sensitivity, but we would have no hesitation in pushing for prosecutions if we found that it was happening.
	So far there have not been any prosecutions but, as I said, some cases are being investigated. Let me give a couple of examples of where we have acted. We have granted asylum to a 19 year-old girl who feared that she was going to be subject to this dreadful barbarity when she went back to her country, and another young girl was granted indefinite leave to remain last spring. My noble friend is right to raise this particularly horrible matter. We take it very seriously and a number of initiatives are under way.

The Lord Bishop of Southwell and Nottingham: My Lords, given that the education of young people is absolutely vital to the elimination of the practice of FGM, what is being done to enhance and resource school nurses in this educational programme? What is being done to promote the DVD produced by the Metropolitan Police under Project Azure?

Lord West of Spithead: My Lords, I thank the right reverend Prelate for his question, which allows me to mention that the Metropolitan Police child abuse investigation command is specifically targeting FGM under Project Azure. This is an enforcement campaign, but it also focuses on raising awareness within communities that this is an illegal practice. It involves working with partners and communities to raise awareness of this issue and to help to protect as many children as possible. The DVD and the £20,000 reward are parts of Project Azure, and the DVD specifically aims to raise awareness among communities and practitioners. As I said, there is a cultural dimension here, but that does not mean that the practice is not still barbarous. Some communities used to practise cannibalism, but that would not be accepted today. It is a difficult issue but we are doing as much as we can to stop this dreadful practice.

Baroness Miller of Chilthorne Domer: My Lords, in asking my question, I pay tribute to the noble Baroness, Lady Rendell of Babergh, for her ongoing campaign on this issue. The statistical study released on 9 October showed that provision of services and education was very patchy across the UK. The Minister has referred to the metropolitan area of London, but what action plan will the Government bring in to ensure that these services are provided throughout the UK?

Lord West of Spithead: My Lords, since the Act came into force, the Department of Health and the Department for Education and Skills have provided information about FGM to doctors and midwives throughout the country. Indeed, as part of my learning experience, I spoke to my younger sister, who is a midwife; it was quite a horrible phone call to find what they have to go through because of what has happened to these poor women. Local authorities, social services departments and the education sector have been spoken to, and information about FGM is contained in Working Together to Safeguard Children, the main multi-agency guidance on safeguarding and promoting the welfare of children. In 2006, the Department of Health produced a separate DVD on healthcare for professionals, as this involves some specialist and difficult procedures, which I do not want to go into. We are working extremely hard on this very important issue. As the noble Baroness mentioned, the numbers involved are quite staggering. Tens of thousands of women may have had this done to them.

Lord Davies of Coity: My Lords, my noble friend the Minister has rightly referred to the barbaric mutilation of children. If, later in life when those children have grown up, they are prepared to bring evidence forward, does he feel that the services are such that prosecutions can successfully be brought about at that time in retrospect?

Lord West of Spithead: My Lords, my noble friend makes a good point. I would have to take advice on how retrospective that action could be. I imagine that action could be taken, but I will have to get back to my noble friend in writing.

Baroness Gardner of Parkes: My Lords, the Minister mentioned the 2003 Act, but that Act is comparatively recent and the offence in this country goes back long before that. I think that he has said that there have been no successful prosecutions. Some cases must result in a post-treatment infection. Those people would then present either to their doctor or to their local NHS treatment centre, which surely should be able to detect things at an early stage. What can be done to improve that process?

Lord West of Spithead: My Lords, the noble Baroness is right that such situations are where these cases are spotted. I mentioned that 20 to 30 cases are being investigated. It is extremely difficult to get people to make statements. There is a cultural issue here; indeed, when I was talking about this issue I found that some of the women involved fear that they will have no chance of marriage unless they go through the procedure because of what happens in their society. That is part of the difficulty. But noble Lords should have no illusions about this; we are intent on doing something about it. The police absolutely have to investigate every case; they are not allowed simply to say, "Oh, this is all a bit difficult". But to end up with someone being prosecuted is very hard. This is a sensitive area, as I have said.

Lord Avebury: My Lords, will the Minister confirm that the majority of the tens of thousands of victims of FGM have already been subjected to the procedure in their countries of origin and that therefore the long-term answer, in addition to the measures being taken by the police in this country, is to build up the capacity of NGOs in countries of origin so that they can persuade those Governments not only to sign up to the Convention on the Elimination of All Forms of Discrimination Against Women but to report promptly on this and take practical measures to stop the practice?

Lord West of Spithead: My Lords, the noble Lord is right. Part of our package of measures is to go out to these countries in conjunction with the NGOs and try to educate and get this message across. We need to educate people and show that this practice is barbaric and an appalling thing to do to women. We hope that by education we can achieve a lot more. The numbers are quite staggering; the World Health Organisation estimates that globally around 100 million to 140 million women and girls have been subjected to this. It is a worldwide issue and that is how we are addressing it.

Lord McColl of Dulwich: My Lords, is the Minister aware that in Ethiopia the incidence of FGM is decreasing and that the degree of it there is minor in comparison to other countries? However, there are places in Africa where the mutilation is appalling. I operated successfully on a little girl of three who had had five of these operations, which had left her completely obstructed and unable to pass urine. The amount of mutilation varies, and in some places the situation is improving.

Lord West of Spithead: My Lords, that is good news. I hope that our education will help to improve matters. It is a barbaric and appalling practice. There are many cases like the one mentioned by the noble Lord that make one go quite cold with anger and revulsion. It is wonderful to hear that in some countries the situation is getting better. I do not know the statistics for each country.

Baroness Masham of Ilton: My Lords, the Minister will probably not be aware that many years ago I took the first female circumcision Bill through your Lordships' House. Is he aware that, if a woman who has had this horrible procedure becomes pregnant, she has to be unstitched? Are all such procedures notifiable? If not, would it not be useful to make them so in order that data can be collected?

Lord West of Spithead: My Lords, the noble Baroness is to be congratulated on first raising this issue. It is something that I had not focused on until I found that I had to talk about it. She is absolutely right. I mentioned talking to my younger sister, who told me about having to cut women open to do these things. I did not want to go into too much detail, as I found it quite hard to listen to and it is difficult to talk about on the Floor of the House. I asked her whether there was a statutory obligation to report this to people and she told me that, although it was not a statutory obligation, it was normally reported. It is an area that we shall have to look at to make it a statutory-type obligation.

Viscount Simon: My Lords, my noble friend has given detailed answers to all the questions, especially on support given in various parts of the country. The Metropolitan Police has been offering a reward of £20,000 for information, but does he know of other constabularies that are giving similar rewards?

Lord West of Spithead: My Lords, I am afraid that I do not know the answer to that one. I shall get back to my noble friend in writing.

Lord Acton: My Lords, is my noble friend aware that, in all the years that I have listened to questions and debates on FGM, his statement today is the most welcome? I congratulate him on it.

Lord West of Spithead: My Lords, I thank my noble friend very much indeed.

Health: Working Hours

The Lord Bishop of Southwell and Nottingham: asked Her Majesty's Government:
	What are the consequences for the health of individuals and for demands on the National Health Service of people regularly working for more than 48 hours per week.

Lord Davies of Oldham: My Lords, weekly hours of work, full time and part time, have fallen from 33.2 in the second quarter of 1997 to 32.2 in the second quarter of 2007. In the past 10 years, the number of full-time employees working more than 48 hours a week has fallen by more than 20 per cent. That followed a period in the mid-1990s when working hours were increasing. While there is evidence that suggests giving people choice and control over their working time can enhance occupational health, research has not shown a clear and unequivocal link between the length of time that people work and ill-health.

The Lord Bishop of Southwell and Nottingham: My Lords, while thanking the Minister for his encouraging reply, does he agree that the nation would be healthier, marriage and family life more sustainable and the costs to the NHS less if we all stopped work for one day a week for rest, relationships and relaxation?

Lord Davies of Oldham: My Lords, the concept of one day's rest a week has a long historical antecedent. The right reverend Prelate is right that in order to enhance family life and improve the upbringing of children it is helpful if parents are at home as often as they can be. But it is for parents to make that judgment—and it may be decided that in order that one partner can stay at home for a very lengthy period the other works slightly longer than 48 hours a week. It is really for families to make that decision.

Lord Skelmersdale: My Lords, with regard to family life, does the Minister believe in the saying, "Absence makes the heart grow fonder"?

Lord Davies of Oldham: My Lords, not in my own case.

Lord Rosser: My Lords, could my noble friend confirm that the most recent survey in 2006 showed that despite the fall that he has referred to, 3.3 million still work more than an average of 48 hours a week over a 13-week period? In pursuit of their programme for family-friendly policies, what measures do the Government intend to take to reduce that figure of some 3.3 million, and will they consider making it possible for complaints over excessive working hours to be pursued through employment tribunals?

Lord Davies of Oldham: My Lords, workers cannot be compelled to work more than 48 hours a week because they have this protection. They can exercise their own choice and opt out—and, as my noble friend indicated, very many do. We recognise that the pressures on some workers to opt out may not be wholly healthy but a reflection of their very low earning power per hour. The Government emphasise that we need to strike a work/life balance that guarantees that sufficient leisure and time at home are available to bring up children. We are concerned that excessive hours can interfere with that. However, workers who are unfairly treated have recourse to tribunals, as my noble friend indicated.

The Lord Bishop of Coventry: My Lords, does the Minister agree that one of the problems inherent in this Question is that there is no definition of the term "work"? Does he also agree that those of us who find that our paid occupation gives us great pleasure would consider that any move to legislate too fiercely in this area would make the Government appear to be killjoys?

Lord Davies of Oldham: My Lords, I recognise the right reverend Prelate's point. I have met one or two noble Lords who share his enthusiasm for work. However, there is a difference between work and hours at the workplace that are entered into voluntarily and contract work. As regards a limitation on hours, we are talking about the worker's contract with the employee. It is important that we recognise that we need to reinforce that position.

Baroness Butler-Sloss: My Lords, does the Minister accept that there may be a different perspective from that of the right reverend Prelate; namely, that employers are very often the reason why many people in all sorts of jobs work very much longer hours? Do the Government think it appropriate to encourage employers to recognise that employees—particularly fathers—may also be parents?

Lord Davies of Oldham: My Lords, that is certainly necessary. I believe that in a changing society employers are becoming more aware of family obligations, particularly given the massive increase in recent decades in the number of mothers who work. That is important. However, I emphasise that the contract is governed by the working time directive. Relationships between employers and their workforce vary widely but enlightened employers have always recognised that they get more productive work from happy and contented workers.

Lord Howarth of Newport: My Lords—

Lord Davies of Coity: My Lords, I am extremely pleased with the Answer that my noble friend gave about reducing working hours in the National Health Service to less than 48. However, could he advise the House on the extent to which workers in the National Health Service who work less than 48 hours but may do a second job outside are taken into consideration?

Lord Davies of Oldham: My Lords, I have difficulty answering that question because the whole House will appreciate that the big issue for the health service was the European Court judgment that looked as if it would greatly restrict the hours that junior doctors could work. That threw the health service into considerable difficulty. My noble friend's point is important but it is a less salient feature than the one to which I have referred.

Baroness Barker: My Lords, can the Minister assure the House that the Government's stated objective of making primary health services available in the early morning and evening will not conflict with the 48-hour directive?

Lord Davies of Oldham: My Lords, the noble Baroness will recognise the extent to which the Government's increased resources for the health service have enabled us to make demands on it to provide much more accessible opportunities for people at work to avail themselves of the requisite services of primary care and GPs. However, we have to take into account her point regarding the danger that some health service workers could be asked to work excessively long hours.

Pakistan: Terrorist Attacks

Lord Ahmed: asked Her Majesty's Government:
	What representations they have made to the Government of Pakistan, in light of the recent terrorist attacks directed at the former Prime Minister of Pakistan Benazir Bhutto.

Lord Malloch-Brown: My Lords, I am sure that all noble Lords will join me in this opportunity to offer our sincerest condolences to the people of Pakistan following the bomb blasts last week in Karachi, and in utterly condemning that attack on Pakistanis exercising their right to express their democratic voice. I assure your Lordships that Her Majesty's Government will continue to support and work with all those committed to building a peaceful and democratic Pakistan. I was visiting the country when the attacks occurred and in my discussions with Prime Minister Aziz, other members of the Government and the chief electoral commissioner, I reiterated the UK's support for the continued preparation for free and fair parliamentary elections in January.

Lord Ahmed: My Lords, I thank the Minister for his reply. Does he agree that although co-operation on anti-terrorism is important, it should not be at the expense of democracy, the rule of law and human rights? Will he assure the House that Her Majesty's Government will not support a single political party or a general in the forthcoming elections, but will respect the decision of the people of Pakistan by supporting free, fair and transparent elections, which he has already mentioned, with the participation of all political parties and the return of the former Prime Minister, Nawaz Sharif?

Lord Malloch-Brown: My Lords, I am very happy to reassure my noble friend that we strongly support free and fair elections in Pakistan and the right of all parties committed to the democratic process to participate in that polling event. That includes the party of Mr Nawaz Sharif. In the mean time, DfID, through the UNDP, has provided some £3.5 million in support of the free and fair conduct of those elections.

Baroness Warsi: My Lords, will the Minister confirm whether there are any outstanding issues of difference between Her Majesty's Government and the Government of Pakistan regarding any organisation or individual who is alleged to have committed terrorist activity in Pakistan but is resident in or operating out of the United Kingdom?

Lord Malloch-Brown: My Lords, I do not think that there are issues of difference; I assure the noble Baroness of that. There are ongoing police investigations in one case. I would not wish to comment on them except to say that where evidence is brought to the police of inappropriate support to terrorist activities in Pakistan, the full force of British law will be brought to bear.

Baroness Falkner of Margravine: My Lords, the Minister emphasised the pursuit of democracy in Pakistan, and that is very welcome. However, does he agree that Pakistan's longer-term security lies in it having a stable future; that a stable future will come about only through national reconciliation, to deal with the challenges of international terrorism, the resurgent Taliban and so on; and that reconciliation will have to involve all the players, including the military, the political parties, the constitutional structures and civil society? Does he agree that that approach—the Commonwealth Heads of Government approach—is the one that in the longer term will deliver what we want?

Lord Malloch-Brown: My Lords, the noble Baroness is absolutely correct to focus on national reconciliation, but the starting point of such reconciliation is a successful election in which everyone can participate. The British Government have been through all the means available to them to stress to all the parties—the political parties, the military, President Musharraf and Pakistani civil society—that there must be a process in which everyone feels that they can participate and own the Government, and that the elections are just a prelude to an extended process of reconciliation in the country.

Lord Howell of Guildford: My Lords, we fully share the concerns about the horror of the atrocity in Karachi and we, too, send our sympathies to the people of Pakistan who want democracy and not bloodshed. We also accept, of course, that we must press for proper democratic procedures to be pursued in Pakistan. Will the Minister also use our own direct influence, such as it is, and our influence through the Commonwealth network—which tends to be rather underused and put aside in government policy nowadays, but which can be valuable in creating pressures for greater democracy and greater freedom in the member states of the Commonwealth network?

Lord Malloch-Brown: My Lords, the noble Lord offers me an important suggestion, as did the noble Baroness. We have a Commonwealth Heads of Government meeting at the end of November. I very much take the suggestion to heart, and we will make sure that we brief our Commonwealth colleagues on what is happing in Pakistan and try to exert collective pressure on behalf of not only free and fair elections but national reconciliation.

Lord Avebury: My Lords, what international organisations have been invited to send observation teams to the elections? Does the Minister agree that it would be far better to send them now, so that they can see that a level playing field is being established, rather than at the last minute when it might be too late?

Lord Malloch-Brown: My Lords, the two groups of which I am aware are the Commonwealth and the European Union. In the case of the European Union, the issue is on the desk of the relevant Commissioner pending a decision. There are questions about the effectiveness of the observation mission, about security issues and so on, but I can assure the noble Lord that we are pressing hard in Brussels for a European mission to be sent in addition to a Commonwealth one.

Business

Lord Grocott: My Lords, with permission, a Statement entitled "Governance of Britain" will be repeated by my noble friend Lord Hunt of Kings Heath after proceedings on the Legal Services Bill.

Crossrail Bill

Lord Bassam of Brighton: rose to move that if a Crossrail Bill is brought from the House of Commons in the next Session of Parliament, the Standing Orders of the House applicable to the Bill, so far as complied with or dispensed with in this Session or in the Session 2005-06 or in the Session 2004-05, shall be deemed to have been complied with or (as the case may be) dispensed with in the next Session.

Lord Bassam of Brighton: This Motion is technical in nature and will, if approved, ensure the Crossrail Bill's continuance into the next parliamentary Session. While not wanting to detain the House for too long, I would like to say a few words about the project.
	Crossrail will benefit London, the south-east and the United Kingdom as a whole. London's success as a major international financial centre is important to the national economy, and unless we invest in more transport capacity we shall all be the poorer. Crossrail will increase access to the capital for hundreds of thousands of workers who commute into London every day. Crossrail will provide a new fleet of trains, operating a 24-trains an hour peak service in both directions through central London and carry an estimated 200 million passengers a year.
	The Bill, if enacted, will allow for the construction of the scheme. This hybrid Bill was introduced into another place on 22 February 2005 and received its Second Reading on 19 July that year with a majority of 375. The Motion today will ensure that the Bill can be carried over for consideration in the next Session. There will be no curtailment of scrutiny next Session. Once the other place has completed its consideration, the Bill will be passed to this House for consideration. In addition to the usual parliamentary stages a Select Committee stage will be added, because the Bill is hybrid. That Select Committee will hear the remaining concerns of petitioners. I issue a general invitation for volunteers to serve on that committee and—if they wish to do so—to come and see me afterwards. I beg to move.
	Moved, That if a Crossrail Bill is brought from the House of Commons in the next Session of Parliament, the Standing Orders of the House applicable to the Bill, so far as complied with or dispensed with in this Session or in the Session 2005-06 or in the Session 2004-05, shall be deemed to have been complied with or (as the case may be) dispensed with in the next Session.—(Lord Bassam of Brighton.)

Baroness O'Cathain: My Lords, when I read the Motion I thought, "What sort of convoluted language is this?". Just for clarification, what does it actually mean? I am slightly suspicious about projects grinding on and on. With the Heathrow Terminal 5 issue in mind, I wonder whether this Motion is a licence to carry on for ever. It is so important for the Bill be sorted out and enacted and for construction to start, for all the reasons that the noble Lord gave, we do not want to provide a licence for delay.

Lord Bassam of Brighton: My Lords, the Motion enables consideration of the Bill to move into the next Session, for one Session only. The noble Baroness, Lady O'Cathain, is absolutely right that we need to crack on with this. The timetable is such that, over the next 10 years, after the parliamentary process, the important work of constructing this fantastic project needs to proceed with all speed.

On Question, Motion agreed to.

Legal Services Bill [HL]

Lord Hunt of Kings Heath: My Lords, I beg to move that the Commons amendments be now considered.

Moved accordingly, and, on Question, Motion agreed to.
	commons amendments
	[The page and line references are to Bill 108 as first printed for the Commons.]
	Page 7, line 15, at end insert-
	"(5A) Where P is an independent trade union, persons provided with relevant services do not constitute the public or a section of the public where-
	(a) the persons are provided with the relevant services by virtue of their membership or former membership of P or of another person's membership or former membership of P, and(b) the services are excepted membership services.
	(5B) Subject to subsection (5C), "excepted membership services" means relevant services which relate to or have a connection with-
	(a) relevant activities of a member, or former member, of the independent trade union;(b) any other activities carried on for the purposes of or in connection with, or arising from, such relevant activities;(c) any event which has occurred (or is alleged to have occurred) in the course of or in connection with such relevant activities or activities within paragraph (b);(d) activities carried on by a person for the purposes of or in connection with, or arising from, the person's membership of the independent trade union;
	and such other relevant services as the Lord Chancellor may by order specify.
	(5C) The Lord Chancellor may by order make provision about the circumstances in which relevant services do or do not relate to, or have a connection with, the matters mentioned in paragraphs (a) to (d) of subsection (5B)."
	Page 7, line 21, after "subsection" insert "(5B), (5C) or"
	Page 7, line 24, at end insert-
	"(9) In subsection (5B), "relevant activities", in relation to a person who is or was a member of an independent trade union, means any employment (including self-employment), trade, occupation or other activity to which the person's membership of the trade union relates or related."

Lord Hunt of Kings Heath: My Lords, I beg to move that the House do agree with the Commons in their Amendments Nos. 4B, 4C and 4D and do not insist on its Amendment No. 4A.
	Noble Lords will recall that, although the Commons had agreed to the Government's amendments to Clause 15 that applied to trade unions, they were not accepted in your Lordships' House. Your Lordships disagreed with those amendments and substituted different words that limited the exemption that trade unions had from the need to be regulated as entities. In our original wording, unions were to have been exempted in respect of any reserved legal services provided by virtue of membership. In the Lords amendment, the exemption applied only to what we might call a limited range of employment-related services.
	The Government looked very carefully at the tenor of the debate in this House and decided that we should accept, in spirit, this House's desire to narrow the exemption. We acknowledged the strength of feeling about the subject and the concerns about the possibility of a reduced level of protection for union members when unions engage in services wholly unrelated to a member's employment, trade, occupation or other membership-based activity.
	I think it would be right to say that, alongside that, no one has wanted to prevent unions continuing to provide legal services to their members in areas connected to their employment, trade, occupation or other membership-based activity. We believe that the services that unions provide are vital for access to justice and for industrial relations, but we certainly see the force in the argument that preserving that position does not require an absolute exemption for all kinds of legal services.
	On that basis, we have tabled amendments of our own which have a similar effect to those that were considered in the other place but which also ensure that services relating to trades, occupations or other activities that relate to a person's union membership are also included.
	Moved, That the House do agree with the Commons in their Amendments Nos. 4B, 4C and 4D and do not insist on its Amendment No. 4A.—(Lord Hunt of Kings Heath.)

Lord Kingsland: My Lords, your Lordships will recall that this issue arose only at a very late stage in another place after the Bill had proceeded through your Lordships' House. The Government sought to exclude trade unions entirely from the scope of Part 5 of the Bill—that is, they would not have to seek a licence if they wished to establish themselves as an alternative business structure. As the Minister rightly drew to your Lordships' attention, we did not seek to oppose that proposal in its entirety; rather, we sought to cut down its scope to apply solely to activities ancillary to the primary trade union function.
	The Bill duly went back to the Commons for reconsideration and, as the Minister rightly said, in the spirit of compromise the Government tabled their own amendment, which goes beyond ours but in no way seeks to reassert the original amendment. We are grateful to the Government for their approach.
	In conclusion, I should remind your Lordships why this has been such an important issue for us. First, in so far as trade unions intend to give services under Part 5, it is not right that their members should receive services to a lower standard than that received by the generality of the consuming public. Secondly, we were and remain bewildered as to why, if trade unions are going to receive this exemption, other non-profit-making bodies ought not also to receive it—I am thinking of mutual societies and organisations such as Citizens Advice. The Government are familiar with this argument, and I shall not press it further. We do not intend to divide on this matter.

Baroness Turner of Camden: My Lords, we debated this in Committee. The government amendment before us meets the objections that I voiced. I was very concerned that the amendment we passed would undermine the services that unions rightfully provide to individual members. This amendment, which has been passed by the other place, deals with the concerns voiced by opponents of that situation. The Government have adequately met all the complaints that were voiced and I am satisfied with the wording.

Lord Thomas of Gresford: My Lords, in my youth I appeared in many cases on behalf of trade union members, instructed by trade unions. In those cases, we were particularly concerned with personal injuries sustained in the course of work. I was acting not on behalf of a trade union organisation, but on behalf of an individual who had suffered a severe injury. What I could not understand about the Government's initial proposal was that it appeared to give some form of protection to the union organisation at the expense of the members. The debates in this House made clear to the Government that they were ignoring the members and looking after the interests of the trade unions. They have obviously shifted from that and we are grateful. We support the amendment.

Lord Mackay of Clashfern: My Lords, this is extremely important, and I am grateful to the Government for recognising the necessity to protect individual trade union members who make use of these services outside the limited scope of the original idea. These services that trade unions offer to their members are extremely valuable, and many members of the trade unions take them up. In the dim and distant past, I had a good deal of experience of litigation in connection with these services. I am happy that this has been resolved in this way, and I congratulate the Minister and all involved on the Government side in settling this so amicably.

Lord Campbell of Alloway: My Lords, I, too, shall say a word of gratitude to the Minister. I spoke against the proposal, he took the point and he has produced a wholly acceptable compromise. I am very grateful.

Lord Hunt of Kings Heath: My Lords, I thank noble Lords for their comments. There is no question that we have now reached an altogether satisfactory conclusion. I am grateful to all noble Lords who took part in the debates and in the discussions of the past 24 hours.

On Question, Motion agreed to.
	Line 10, at end insert-
	"and, in preparing that statement, the Board must have regard to the principle that the Board should not exercise any of those functions by reason of an act or omission of an approved regulator unless the act or omission was unreasonable."

Lord Hunt of Kings Heath: My Lords, I beg to move that the House do agree with the Commons in their Amendment No. 15B and do not insist on its Amendment No. 15A.
	Noble Lords may recognise the substance of the amendment made in the other place. When we considered this important issue of the relationship between the overarching board and the individual regulators, the noble Lord, Lord Kingsland, tabled Amendment No. 15A that added to Commons Amendment No. 15 and would mean that policy statements published by the board must:
	"ensure that the Board exercises its powers only where it considers that the action or inaction of an approved regulator is not an approach which the approved regulator could reasonably have taken".
	I agree very much, as I said at the time, with what the noble Lord said in the debate about the role of the oversight regulator and the individual bodies, and making sure that the balance is right and that the individual regulators are not micromanaged by the board. The concerns that I raised were that an absolute reasonable success must be shown before taking any action that might fetter or restrict the board from taking action in appropriate circumstances.
	Commons Amendment No. 15B, however, requires that the board's policy statements must have regard to the principle that the board should not exercise any of those functions by reason of an act or an omission of an approved regulator unless the act or omission was unreasonable. With the existence of any such policy statement, the board would clearly have to demonstrate how it had had regard to that principle when exercising its powers. I hope that noble Lords would agree that this amendment now satisfies concerns raised previously.
	Moved, That this House do agree with the Commons in their Amendment No. 15B and do not insist on its Amendment No. 15A.—(Lord Hunt of Kings Heath.)

Lord Kingsland: My Lords, I am most grateful to the noble Lord for the amendment he has placed before your Lordships today. The issue that lies behind it can be put very simply—in fact, as it was by the Minister in another place in a debate that took place on this Bill about a week ago. The Minister said that the Legal Services Board should not seek to second-guess the decision of the approved regulators. It is plain that if the approved regulators act reasonably in reaching their decisions, the Legal Services Board should not intervene. The only basis on which it should intervene would be irrationality. The amendment that the Minister has placed before your Lordships' House, while not 100 per cent meeting the text I would like, nevertheless has gone a long way to do so, and I am content.

Lord Hunt of Kings Heath: My Lords, I am very grateful. I should like to make it clear that whatever the debate over the wording, I do not think that there is anything between us in the constructive relationship that we want to see between the board and the individual regulators.

Lord Kingsland: My Lords, the Minister has just made an extremely helpful addition.

On Question, Motion agreed to.
	Page 121, line 6, leave out "with the concurrence of the Lord Chief Justice"
	Page 121, line 10, leave out "with the concurrence of the Lord Chief Justice"
	Page 121, line 12, at end insert-
	"( ) Before appointing an ordinary member, the Lord Chancellor must consult the Lord Chief Justice about the process for appointment of the member and about the person selected for appointment."
	Page 121, line 16, leave out "and Lord Chief Justice"
	Page 122, line 17, leave out "and Lord Chief Justice"
	Page 123, line 6, leave out "with the concurrence of the Lord Chief Justice"
	Page 123, line 8, leave out "and Lord Chief Justice"
	Page 123, line 11, leave out "and Lord Chief Justice are" and insert "is"
	Page 123, line 21, leave out sub-paragraph (5)
	Page 123, line 23, leave out "the Lord Chancellor and Lord Chief Justice remove" and insert "removing"
	Page 123, line 24, leave out from "member" to end of line 25 and insert "under sub-paragraph (1)(b), the Lord Chancellor must consult-
	(a) the Lord Chief Justice, and(b) if the ordinary member is not the chairman, the chairman."
	Page 123, line 26, leave out "and Lord Chief Justice"

Lord Hunt of Kings Heath: My Lords, I beg to move that the House do agree with the Commons in their Amendments Nos. 88B to 88M in lieu of Commons Amendments Nos. 74 to 77 and 81 to 88, to which this House disagreed.
	We turn again to the important role of the Lord Chief Justice in appointments to and removals from the Legal Services Board. I am a late entry in the debates that your Lordships have undertaken on this matter, but I know that there has long been genuine concern about, first, the role of the Lord Chief Justice in consultation, and then, following the amendments made in the other place, what role the Lord Chief Justice might involve—is consultation to be real or not?
	I confirmed in our last discussions that my honourable friend Bridget Prentice had written to the Lord Chief Justice to consult him on the process we are undertaking for the appointment of the chair of the board. The consultation with him focused on the criteria against which candidates for the position of chair are judged. He asked to look at the draft specifications for the chairman of the board, and was invited to comment on the process we are undertaking, including composition of the appointments panel and how the campaign will be carried out in line with guidance issued by the Commissioner for Public Appointments. He was also invited to suggest names of potential candidates whom the recruitment consultants may wish to contact. I confirm that my honourable friend will write again shortly with respect to the other members of the board.
	The reason why the Lord Chief Justice has not yet been written to is that the chairman will sit on the appointments panel. Clearly, it is important that the process for appointing the chairman be concluded before consultation takes place on the appointment process for other members. Following that debate, we took away the points made about clarifying the role of the Lord Chief Justice and agreed that it would be helpful to set them out in the Bill, especially in the light of the discussions that your Lordships' House undertook only a few days ago. The amendments being brought forward from the other place are intended to do exactly that, requiring the Lord Chancellor to consult the Lord Chief Justice on both the appointment process and the final selection.
	In clarifying that role, Amendments Nos. 88B to 88M meet the concerns raised previously in both Houses, while ensuring that the Bill is compatible with best practice in relation to public appointments.
	Moved, That the House do agree with the Commons in their Amendments Nos. 88B to 88M in lieu of Commons Amendments Nos. 74 to 77 and 81 to 88, to which this House has disagreed.—(Lord Hunt of Kings Heath.)

Lord Neill of Bladen: rose to move, as an amendment to Motion C, leave out from "House" to end, and insert, "do insist on its disagreement to Commons Amendments Nos. 74 to 77 and 81 to 88, do disagree with the Commons in their Amendments Nos. 88B and 88C and 88E to 88M, do agree with the Commons in their Amendment No. 88D, and do propose Amendment No. 88N as an amendment thereto—
	Leave out lines 3 and 4 and insert "obtain the concurrence of the Lord Chief Justice".

Lord Neill of Bladen: My Lords, I begin with the declaration of interest that I have many times made in debates on the Bill: the first is that I am a member of the Bar; the second is that in the past I served for many years on the Bar Council; and the third is that I held the office of Chairman of the Bar. But I am not today a spokesman for the Bar Council and I have not been privy to the discussions which it has had with the Minister; I am an independent Cross-Bencher.
	We have before us an important policy issue. There are a lot of words in the amendments, but they really boil down to the overriding importance of the Legal Services Board, because it will be an overarching board—overarching, among others, the professions of barrister and solicitor. The view that I advance is that, that being a body of such enormous and wide-ranging powers, it is appropriate that the appointments to and removal from the board should have the concurrence of the Lord Chief Justice.
	I stated last time my understanding of the meaning of the word "consultation" and cited a case, or gave the details of a case, but there has been no comeback on that point. It is clear that consultation is weaker than concurrence. My primary point is to persuade this House to re-establish the position as we established it in many votes in the past and to insert the words,
	"concurrence of the Lord Chief Justice",
	in all the appropriate positions.
	I should like to say one thing about consultation. We are now faced with an extension in the legislative intent as regards consultation with the Lord Chief Justice. Under the language that I have seen, it will certainly cover the appointments process and may indeed go beyond that, if one has regard to the correspondence that has evidently been taking place between one of the Ministers and the Lord Chief Justice. I say nothing about that, because I have not seen the correspondence.
	I have a point of principle on consultation. That is that the more that the Lord Chief Justice becomes involved in the process of setting up the board and the criteria for selection, the closer that we get to risking a conflict between separate powers of the state. Your Lordships will recall very well that we set up a Supreme Court in order to protect the principle that the judiciary and the legislative role were in no way in conflict. Similarly, in a scene that can be conjured up in one's mind's eye, the Lord Chief Justice could, by this route—which includes one of the amendments made in the Commons—be drawn into the consultation process and become, as it were, part of the machinery of government. No doubt that will be hotly denied, but it is a risk that it is possible to envisage.
	My primary point is about who makes the ultimate decision on who holds these jobs and how they can be removed. My view is that it should be the Lord Chief Justice. There has been some reference in the past to a code of practice under some other legislation, in which it is made clear that the Minister is, as it were, the top man, and has the ultimate responsibility for appointing the various offices. The short answer to that is that we are discussing not a code but primary legislation, and it is your Lordships who are taking a view on the correct decision. Should the Bill provide for the concurrence of the Lord Chief Justice, so that he can prevent an election of which he disapproves, or will mere consultation be good enough? That is the issue. I beg to move.
	Moved, as an amendment to Motion C, leave out from "House" to end, and insert "do insist on its disagreement to Commons Amendments Nos. 74 to 77 and 81 to 88, do disagree with the Commons in their Amendments Nos. 88B and 88C and 88E to 88M, do agree with the Commons in their Amendment No. 88D, and do propose Amendment No. 88N as an amendment thereto.—(Lord Neill of Bladen.)

Lord Kingsland: My Lords, we have from these Benches supported the noble Lord, Lord Neill of Bladen, in his amendment on two occasions. The matter has now come back to us for a third time.
	I have no doubt that when the Minister comes to speak, he will draw our attention to the fact that both the Joint Committee and the original report drafted by Sir David Clementi were content with consultation and did not require concurrence. However, between then and now, there has been one very important constitutional change: that is, the sending of the Chancellor from your Lordships' House to another place. The Lord Chancellor is now an elected politician, subject to party discipline, and may one day—I make no adverse observations about the present incumbent—find the influence of politics stronger than the influence of justice. Indeed, there are important questions to be asked about the suitability of a policy ministry, such as the Ministry of Justice, having responsibility for judicial matters. However, that is a debate for another day.
	As a result of this important constitutional change, we became more enamoured of the terms of the amendment of the noble Lord, Lord Neill of Bladen. Originally, the Government were simply not prepared to accept even consultation; the decision was to be made by the Lord Chancellor alone. But their position shifted in another place, and the Government began to spell out what they meant by consultation. The matter came back to your Lordships' House and we sent it back, robustly, again. The Minister in another place, Bridget Prentice, has now been a great deal more explicit about what is meant by consultation. Many view the inclusion under Schedule 1 of the requirement for the Lord Chief Justice to be consulted on the process as well as the name of the members of the Legal Services Board as very helpful.
	The noble Lord, Lord Neill of Bladen, by contrast, has drawn to our attention the fact that, in a sense, concurrence respects much more what the Government told us they were aiming at in their judicial reforms two years ago than consultation. This is because the process of consultation enmeshes the Lord Chief Justice in the political process. I take that to be the point made by the noble Lord, Lord Neill of Bladen. That should give us cause for hesitation if we are going to vote for the Government on this matter today. However, for my part, the Government have responded in the direction to which they have been drawn by those who have contributed to debates both in another place and here.
	I still prefer the drafting of the noble Lord, Lord Neill of Bladen. I believe that there are great dangers in establishing, on the one hand, an independent judiciary with a process that is plainly separate from the political process but not taking the same approach to the membership of the organisation that will oversee the legal profession. It is constitutionally dangerous because, as I have had the opportunity to say on a number of occasions, one cannot have an independent judiciary unless one has an independent legal profession: and, indeed, vice versa. I hope that the Government will bear that in mind under their new procedures. I assure them that we will watch them very carefully.
	I would like to have voted for the noble Lord, Lord Neill, again; but the constitutional position of your Lordships' House in relation to the Commons on this is clear. There are times when we will go right to the end in exercising our rights in the parliamentary procedure; but I say, to some extent with a heavy heart, that this is not one of those occasions.

Lord Thomas of Gresford: My Lords, I am sorry that the Conservative Party is taking a different view and is resiling from very important principles. The noble Lord, Lord Kingsland, was right to emphasise that the independence of the judiciary demands an independent Bar and an independent Law Society. Solicitors must be as independent in the advice that they give to their clients as members of the Bar are.
	Only those of us who have practised in jurisdictions where there is no independence know just how devastating it can be to appear, knowing that the result is foretold. The independence of the judiciary is under attack in a number of places in the world. The most senior chief justice in Pakistan is supported by independent lawyers, who have taken to the streets to defend this principle. It is so important that I regret that those on the Benches next to me are resiling from it. We have supported the noble Lord, Lord Neill, throughout, and we shall continue to do so.

Lord Campbell of Alloway: My Lords, I, too, regret this, but we have come to the stage where we should no longer insist. Therefore, I follow the line that my noble friend Lord Kingsland has taken.

Lord Hunt of Kings Heath: My Lords, I, like the noble Lord, Lord Neill, believe that this is a very important matter. Equally, he was right to emphasise the importance of the Legal Services Board. I have already set out the reasons why the Government have clarified in statute what the consultation with the Lord Chief Justice will entail. I will come to the point made by the noble Lord, Lord Neill, about the degree of involvement by the Lord Chief Justice in consultation. The noble Lord is really suggesting that the involvement is too great, which interferes with the separation of powers. I will return to that point in a moment. We should remember—the noble Lord, Lord Kingsland, kindly reminded us—that the Commons amendments before your Lordships' House are consistent with the original recommendation of Sir David Clementi's report and with the recommendations of the Joint Committee on the draft Legal Services Bill.
	The noble Lord, Lord Neill, referred to the code of practice in the making of public appointments and said, quite rightly, that we can override that code today through primary legislation. However, the code arose because of concerns, over many years, about the way in which public appointments were made. The adoption of the code has led to a much more rigorous approach to public service appointments, and when we come to the Legal Services Board, it is important that the spirit of the code is adopted in this way.
	I know that the noble Lord, Lord Neill, is concerned, and I read out the detail of the involvement of the Lord Chief Justice in the consultation process. I assure the noble Lord that the Lord Chief Justice is content with that process, and although I do not agree, I understand the noble Lord's point about the involvement of the Lord Chief Justice. However, I would argue that "concurrence", which essentially gives a veto to the Lord Chief Justice, gives him much more ownership of that appointment. I suspect that we will not agree on that matter.
	I say to the noble Lords, Lord Kingsland, and Lord Thomas of Gresford, that of course the independence of the judiciary is critically important. I know that noble Lords are disappointed that the office of Lord Chancellor is now held by a Minister in the House of Commons—I draw that distinction before the noble Lord, Lord Kingsland, corrects me. However, I point to the Constitutional Reform Act 2005, which lays a clear responsibility on:
	"The Lord Chancellor, other Ministers of the Crown and all with responsibility for matters relating to the judiciary or otherwise to the administration of justice must uphold the continued independence of the judiciary".
	One cannot say fairer than that. We are determined to uphold the independence of the judiciary.
	The Legal Services Board is an important board: the noble Lord, Lord Neill, is right to suggest that. In view of its importance it is right that, at the end of the day, the Lord Chancellor, as a Cabinet Minister, is accountable to Parliament for that judgment, but it should be made in consultation with the Lord Chief Justice. We have discussed this on a number of occasions. I know that there is not agreement on all sides of the House, but the Government have listened and moved considerably. I hope that we will be able to take this through the House today.

Lord Neill of Bladen: My Lords, I will say just a few words in reply. I listened to the speech of the noble Lord, Lord Kingsland. The opening few paragraphs seemed to be rather good, but unfortunately the quality was not maintained and he ended with a view about how he and his cohorts intended to proceed which I did not hear with any pleasure.
	I am very grateful to the noble Lord, Lord Thomas of Gresford, who believes in the principle that I am contending.
	As for the Minister, I thank him for the graciousness with which he dealt with my position, and his courtesy—I suppose you would call it that. However, he is wildly optimistic if he thinks that any court will construe the words,
	"must consult with the Lord Chief Justice",
	even if accompanied by a "consultation on process", as being stronger than the words,
	"concurrence of the Lord Chief Justice".
	I see that he is shaking his head; perhaps I do him an injustice.

Lord Hunt of Kings Heath: My Lords, I do not disagree with the noble Lord. Clearly, concurrence that gives a veto to the Lord Chief Justice is a degree more weighty than consultation. My argument is that consultation is the appropriate mechanism.

Lord Neill of Bladen: My Lords, it is not being suggested that the Lord Chief Justice is in a more powerful position through the language which will go into the Bill if the Commons view prevails. I shall not add any more words. We all know the issue. I wish to test the opinion of the House.

On Question, Whether the said Motion (No. C1) shall be agreed to?
	Their Lordships divided: Contents, 70; Not-Contents, 111.

Resolved in the negative, and Motion disagreed to accordingly.
	On Question, Motion C agreed to.

Governance of Britain

Lord Hunt of Kings Heath: My Lords, with the leave of the House, I shall repeat a Statement made by my right honourable friend the Secretary of State for Justice in another place. The Statement is as follows:
	"Mr Speaker, with permission, I should like to make a Statement about our programme of constitutional renewal. With this Statement, three consultation documents are being published. The first, jointly by my right honourable friends the Foreign and Defence Secretaries and me, is on parliamentary approval for war powers and treaties; the second, by me, is on judicial appointments; and the third, by my right honourable friend the Home Secretary, is on protests in Parliament Square. Copies of the documents are available in the Vote Office and on my department's website."In his Statement to the House on 3 July to launch the Green Paper, The Governance of Britain, my right honourable friend the Prime Minister set out his vision of a renewed relationship between government and citizen. He identified 12 areas in which,
	'the Prime Minister and executive should surrender or limit their powers, the exclusive exercise of which by the Government should have no place in a modern democracy'.
	"Two of the most important prerogative powers exercised by government are the power to deploy the Armed Forces overseas and the power to commit the nation to international legal obligations through the ratification of treaties. "I turn first to war powers. On 15 May, the Government supported a Motion in this House which declared that it was 'inconceivable' that the precedents set in 2002 and 2003, when the Government sought the approval of the House for military action in Iraq, would not be followed in the future. The same Motion called on the Government,
	'to come forward with detailed proposals',
	on how this convention should be entrenched. Today's consultation paper therefore explores a range of options, each aimed at formalising Parliament's role. It suggests that this might be through a convention, through legislation, or by a combination of both."The consultation paper discusses the critical issues that any system would have to accommodate. It is essential that any new arrangement should not damage morale, hinder us in meeting our international commitments, or inhibit operational flexibility. Nor should it place members of our Armed Forces under any legal liability as a result of any new arrangement. The Government welcome views on how these objectives can best be achieved and on related questions. What is the role of the House of Lords? How should we define 'armed conflict' and 'armed forces'? What information ought to be supplied to Parliament and at what stage?"I turn now to the ratification of treaties. This is already subject to a parliamentary convention, introduced by the first Labour Government in 1924, known as the Ponsonby Rule. According to this and with certain exceptions, the Government must lay a treaty as a Command Paper before Parliament for a minimum of 21 sitting days prior to ratification. It is then for Parliament to determine which treaties it wishes to debate. The Government believe that there may be value in putting this convention on a statutory footing, to establish Parliament's right to decide and to show that the actions of the Government are subject to the will of the people's representatives."The paper seeks views on how this can best be done, including on the detailed and important questions of how exceptions to the existing convention, such as bilateral double taxation agreements, should be dealt with; how a debate and vote on a treaty should be triggered; and how the 21-day period could be extended in special circumstances."As Lord Chancellor, I am responsible for upholding and defending the independence of the judiciary, which is essential to the functioning of any free and democratic society. Our system of appointing judges must be, as I believe it is, wholly devoid of party politics. It must be transparent, accountable and capable of inspiring public confidence. Under the Constitutional Reform Act 2005, with the establishment of the Lord Chief Justice as the head of the judiciary, we have already made many significant reforms to the way in which judges are appointed in England and Wales. The most fundamental was the creation of an independent Judicial Appointments Commission. The consultation paper published today outlines possible options for additional reform, on which the Government would welcome views."The final consultation document published today concerns protest in Parliament Square. The framework in the Serious Organised Crime and Police Act 2005 in respect of protests raised concerns from campaigners, other citizens and, separately, from Members of this House. We need to listen to those concerns and review the provisions to see whether there is a better way to uphold the right to protest and manage individual protest appropriately. "Holding the Government to account for the way they spend public money is one of the most important functions of this House. I and my colleagues pay tribute to the work of the National Audit Office in supporting Parliament in this task. So the House will be pleased to know that, following a joint request from the Father of the House and the opposition chairman of the Public Accounts Committee, space will be made available in the constitutional reform Bill for any agreed changes to the governance of the National Audit Office emerging from the review that it has announced."It is right to consider the circumstances in which we open up more information for debate before this House. Even in the most sensitive sphere, national security, where everyone agrees that some safeguards have to be in place to respect confidentiality, we should always consider where we can do more. Starting next month, the Government will publish annually, for parliamentary debate and public scrutiny, our national security strategy, setting out for the British people the threats that we face and the objectives that we pursue. Additionally, new rules will govern a more open approach to the working of the Intelligence and Security Committee. My right honourable friend the Prime Minister has agreed with the chair of that committee that Parliament should have a clear role in the appointment of its members."In keeping with this Government's commitment to ensure that the public can access the information that they need, my right honourable friend the Prime Minister will be making a speech later today announcing that we will not tighten the charging arrangements for freedom of information requests. A consultation on whether to extend the Freedom of Information Act to a range of organisations that perform public functions and a review of the 30-year rule will be established."These days huge amounts of personal data are held by the public and private sectors. My right honourable friend the Prime Minister and I have asked the Information Commissioner, Richard Thomas, and Dr Mark Walport, director of the Wellcome Trust, to review the way we share and protect personal information in the public and private sectors. "The freedom of the media to investigate and report is a key issue in the use of information. We consulted last year on restricting media access to the coroners' courts and I can now confirm that we will not be limiting access. Proposals to ban media payments to criminals have been under consideration for some time. None of us wants to see criminals profiting from publishing books about their crimes and, while ensuring that the freedom of the press to investigate and report is maintained, we will make sure that criminals cannot benefit in that way."As provisions in the Criminal Justice and Immigration Bill make clear, we are also concerned about the misuse of personal data. However, the new rules raise concern that they could impede legitimate investigative journalism, so the Information Commissioner, in consultation with the Press Complaints Commission, will produce clear guidance to ensure that that is not impeded."There is often a lack of clarity in the balance between an individual's freedom and the role of the state. My right honourable friend the Home Secretary has been examining this issue in relation to existing police powers of entry, to consider whether there should be a single readily understandable code. The Home Secretary will widen the review in scope to include all powers of entry held by public authorities. The Home Secretary will also lead a consultative review considering whether improved guidance is needed for police officers in the exercise of Section 44 of the Terrorism Act 2000, ensuring that trust is preserved in the use of those powers."These consultation documents and these other measures are all in part concerned with the right to freedom of expression and its facilitation. It is a right specifically protected by the Human Rights Act, but it has existed in the UK for a very long time. Because of its fundamental importance in our democracy, I shall be considering how, as all future legislation is developed, it can be carefully audited for any explicit or unforeseen restriction that it might unnecessarily place on freedom of expression."These are important questions that go to the heart of the issue of where power should lie in our country and how it should be exercised. We now look forward to hearing the views of parliamentarians and citizens on how this can best be achieved in these vitally important areas".

Lord Kingsland: My Lords, I find myself in some difficulty in responding to the Statement. At about 11.40 am, while I was engaged in the debate on the Legal Services Bill, I was handed three documents, which, as I understand it, form the basis of the ministerial Statement. It is simply not possible to respond to substantial parts of the Statement without reading the documents first. I shall give the Minister one example. He suggested that the Government might be looking further at the issue of judicial independence and, at the end of the paragraph dealing with that matter, he stated:
	"The consultation paper published today outlines possible options for additional reform, on which the Government would welcome views".
	However, since I have not the faintest idea what those options are, it is not possible for me to respond in any constructive sense. Indeed, I find myself, being in total ignorance of the contents of these documents, at a loss to know how I should respond. Nevertheless, of course, I shall.

Noble Lords: Ha!

Lord Kingsland: Not for the first time, I shall talk about something that I know absolutely nothing about, my Lords.
	The first issue that the Minister addressed was the decision-making power of Parliament to approve a declaration of war. The Statement rightly said that there was a long and constructive debate in your Lordships' House last May on this topic.
	The difficulty that all Governments surely face on this issue is that they cannot be fully frank with Parliament. There is a whole range of intelligence information that is crucial to the decision whether or not to go to war that simply cannot be made public. Parliament will always be making a decision on trust. The issue about war-making decisions, therefore, is not actually Parliament's vote, although that is now a crucial component, but rather the confidence that Parliament can repose in the recommendation of the Government to go to war. That in turn depends on Parliament's confidence in the main actors in that decision: the Chiefs of Staff, the intelligence services and those ministries that have been involved in the build-up—in particular, the Ministry of Defence and the Foreign Office.
	Those of your Lordships who have read the Hutton and Butler reports on the events leading up to the Iraq war will recall that many sharp criticisms were made of the process by which the Government took advice from all these agencies before making their final decision. I think that the expression used by Lord Butler encapsulated that process: "sofa government". It was quite plain that many of those important institutions were not consulted in a full and objective way. What we need to hear from the Government in future is not so much the claim that they will consult Parliament; we need to be sure, before we can make a proper decision, that the Government have consulted all those agencies properly and that the Statement on this issue to Parliament reflects their view.
	On treaties, I am most unimpressed with what the Minister said about the Government's intentions. The crucial thing about treaties is not the ratification but the signing process. What Parliament needs is an opportunity to engage with the Government about the process of negotiating before a treaty is signed. A classic example of this was the signing by Mr David Blunkett, then Home Secretary—in secret in the United States, without even telling his Minister of State—of a treaty on extradition that gave away the individual rights of citizens in this country. That was a particularly disgraceful thing to do when individual constitutional rights were involved. What your Lordships' House ought to want to know is not what the Government are going to do about ratification but how they will engage Parliament in the process leading up to signature. Once a Government sign a treaty there is absolutely nothing that anybody can do about its contents; they are binding on the state under international law. So the Government have a great deal more thinking to do on the question of signing treaties.
	As I said at the beginning, I have not the faintest idea what the Government are going to say about judicial appointments. It was only two years ago that the Government declared themselves completely satisfied with what they had put in the Constitutional Reform Act. They removed the responsibility for selecting judges from the Lord Chancellor, accountable to Parliament, to an entirely independent judicial appointments committee. I think that there were some merits in that, up to a point: the committee presents its conclusions to the Lord Chancellor, but the Lord Chancellor has almost no room for manoeuvre about whom he or she ultimately appoints.
	Have we gone too far in the other direction? Do we have enough parliamentary accountability in making judicial appointments? In the United States, they have for senior judicial appointments an advise and consent procedure with the Senate. I have not yet met a Supreme Court judge who has not said that he values that process, because it in some way legitimises the enormously powerful role that he has under the American constitution.
	As a result of the Human Rights Act and other measures in legislation—and particularly because of the weakness of the House of Commons in controlling the Government—judges are being more and more drawn, ineluctably, into political decision-making. They are certainly perceived as being drawn in more and more. If they are to be drawn into political decision-making through their decisions, surely there must be a case for giving their appointment parliamentary legitimacy. Do the Government in this document—which I have not yet read—propose that, or are they on an entirely different tack, which is nothing whatever to do with what I have just said? I do not know.
	I was interested in the Minister's remarks on national security. This is a matter of great complexity and delicacy. I would like to know more about the proposals before I give an off-the-cuff response—and likewise on the question of media. There is simply not enough content here yet for me to make a sensible observation.
	In closing, I was not surprised, although I was disturbed, to see that the Government intend to institute a programme of constitutional renewal. That sounds extraordinarily radical, and I invite the Minister to say a little more about it. No constitution is perfect; but, when one looks back on the past 300 years, I respectfully suggest that ours has done rather well if one compares it with almost everybody else's. Ours has been endorsed by every single generation since 1688 and, on the whole, not found wanting. So why does this generation and why do this Government suddenly decide that the constitution needs renewal? I suggest that they should look much more carefully at why we have the constitution that we have before embarking on yet another round of radical change.

Lord Tyler: My Lords, I have had just a few more minutes than the noble Lord, Lord Kingsland, to examine the Statement and the consultation documents. This is as much as anything a restatement in a number of important directions but, nevertheless, my noble friends and I welcome it.
	To deal with easy matters first, we very warmly welcome the decision to review the rights of democratic protest. We always thought that it was ridiculous to include in the Serious Organised Crime and Police Act 2005 an attempt to try to control the rather messy experiences that we witness daily in the middle of Parliament Square. It was not an appropriate vehicle for dealing with the very proper right of the British citizen to protest in public and close to where we hope these decisions will still be made—in the Palace of Westminster.
	We must examine the issue of judicial appointments with extreme care, for the reasons that the noble Lord, Lord Kingsland, has already advanced, because in our constitution we have a rather ineffective separation of powers. The noble Lord himself has probably gone all over the world advising new democracies on the necessity of keeping separate the judiciary from the legislature and Executive. Until quite recently we had here on the Woolsack someone who was a member of the Cabinet and therefore a part of the Executive, a member of the legislature as a Member of this House, but also the supreme head of the judiciary. That was quite extraordinary. So whatever methods we are going to adopt, we shall have to look at extremely carefully.
	With any sort of confirmatory hearings, surely the real confirmatory hearings should be for those responsible to Parliament. New Secretaries of State should surely come before either Joint Committees or Select Committees of the other House.
	As the Statement has made clear, there are 12 areas in which the royal prerogative could be re-examined—and only a few are dealt with in the process in front of us today. There is no reference to the dissolution of Parliament, which may in the light of recent events be rather more significant and urgent than the issues that are in the Statement. It would be extraordinary if the Government so lost their majority in the Commons that they could not carry the day on that issue—and, if they can carry the day, the only effect in terms of real change to the balance of power in this country would be a further restriction on the monarch, who in certain circumstances can potentially still have a view on that matter.
	On the war-making powers and treaty ratification, we look forward to hearing the Government's proposals for your Lordships' House. We believe that in both cases there is a role for us in this place, as well as the other place; but we are very strongly in favour of placing the issue of treaty ratification on a statutory basis. We do not believe that an informal convention is sufficient.
	In the Statement there is also a welcome change in the Government's attitude on the issue of requests for freedom of information. We very warmly welcome the decision to review that; we thought that it was anti-democratic that the charging regime should have been ratcheted up on the basis of previous proposals. We also welcome the decision to look again at how the resources of the National Audit Office could be made available to both Houses.
	The future of the Human Rights Act is only very briefly mentioned at the end of the Statement but we understand that it will be the subject of a rather fuller explanation of the Government's policy from the Prime Minister outwith Parliament today. We believe that the Act needs strengthening, not weakening, and we shall examine that very carefully.
	What are not in the Statement but are in the Green Paper are matters that we believe are equally urgent to those that are contained in it. Nothing more need be said about House of Lords reform at the moment—but one hopes that in the next couple of weeks we will hear more. The concordat referred to in TheGovernance of Britain Green Paper between central and local government is a really urgent issue and nothing has been said about it. Members of your Lordships' House will recall that on all sides and in all parties the relationship between central and local government is considered to be at a critical stage, and this concordat will be very important.
	At the time of the Green Paper much reference was made to a proposed Speaker's Conference. What is the remit for that conference? What will be the representation in that conference, and what is the intended timescale? The noble Lord, Lord Kingsland, said that our constitution does not need renewing. These Benches believe that it certainly does, and for one very important reason. It is surely an absolute basic right of every British citizen to be confident that his or her vote is equal in value to that of every other citizen. Surely in a representative democracy that is a very basic citizen's right. Given that there is now wide recognition that three-quarters of the electorate have no impact on the outcome, and their vote is therefore wasted, when will Ministers release their internal departmental examination of voting systems? We have long been promised the report. It was referenced in the Green Paper in paragraph 156 that it was imminent and should be with us before the end of the year. The end of the year is coming very swiftly. When will the Government accept that this gross distortion at the heart of the democratic governance of Britain should at least be referred to the Speaker's Conference and to a general wider consultation among the public? Otherwise at the very heart of the Government's proposals there is an aching void.

Lord Hunt of Kings Heath: My Lords, I am grateful to both noble Lords for their comments. Given that he was not able to read the documents, the noble Lord, Lord Kingsland, did very well indeed. I would have no hesitation hiring him as my lawyer if ever the need arose.
	Of course, I understand that the documents that were released alongside the Statement are weighty and need and deserve great care and consideration by your Lordships, the other place and members of the public. We very much welcome the contribution of all noble Lords to the debate. These are very much consultation documents. Many of the recommendations are not firm; they are ideas, suggestions and options. I am sure that we shall all have an opportunity to debate them much more fully over the coming weeks and months.
	The noble Lord, Lord Kingsland, referred to one of the most important papers in many ways—that concerning war powers. I agree with him that the provision of information to Parliament when it is called on to make such a weighty decision is absolutely critical. I accept that there will always be a balance to be drawn between the needs of security and sometimes diplomacy and the need to give as full information as possible to parliamentarians. Those matters are rehearsed—

Lord Renton of Mount Harry: My Lords—

Lord Hunt of Kings Heath: My Lords, I shall respond to the Front Benches first and then we have 20 minutes for other noble Lords to make their points.
	The consultation paper looks at the very issues that the noble Lord, Lord Kingsland, raises. It also suggests that an appropriate Joint Committee of both Houses might consider some of the more sensitive information. However, I have no hesitation in saying to him that this is a matter to which we must give very great attention.
	The noble Lord, Lord Kingsland, made other extremely important points. As regards treaty ratification, often a long time may elapse between original discussions and actual ratification. It is important that parliamentarians are able to debate the principles at the beginning of the process as well as ratification of the treaty at the end. Ratification is very much at the end of the process. It has been the practice of successive Governments to make changes in domestic legislation to ensure that they comply with the treaty before the ratification process is brought to Parliament. My experience of treaties that I have been involved in relating to health and children is that there have been many opportunities for noble Lords and Members in the other place to debate these matters.
	The noble Lord, Lord Kingsland, referred to judicial appointments and we again discussed the issue that we debated during proceedings on the Legal Services Bill. I echo what he said about the importance of the independence of the judiciary. The consultative paper presents a number of options for reducing the role of the Executive in the judicial appointments system; for example, the ability of the Lord Chancellor to reject a selection by the Judicial Appointments Commission could be reduced. The ability of the Lord Chancellor to require the Judicial Appointments Commission to reconsider could be reduced or removed. The Lord Chancellor's role could be reduced to a largely formal one, although he could question the process used by the Judicial Appointments Commission. There could be a complete surrender of the Executive's role with responsibility transferred to, for example, the Judicial Appointments Commission. Those are all options that will fall to be considered.
	The noble Lord, Lord Kingsland, raised a very interesting point about the role of Parliament. In the consultative paper the Government say that they have serious doubts about pre-employment hearings as a way to identify the best candidates on merit. They are concerned about the risk of politicisation in that process. They have concerns about non-binding hearings before confirmation but after the appointments process for the same reason. They go on to say that some form of hearing might be more suitable for very senior judges, not in the context of what are described as post-appointment hearings but more to allow those senior judiciary appointments to discuss issues in relation to the administration of justice. I am very happy to take on board the comments of the noble Lord, Lord Kingsland, on this, and I am sure that he will want to contribute further.
	I am grateful for the welcome that the noble Lord, Lord Tyler, gave to some aspects of the papers. He is right to stress that extreme care must be taken with judicial appointments. I hope that he will read the paper with great interest. I look forward to debating it with him. As regards confirmatory hearings, I am not sure that I completely agree with his remarks about a new Secretary of State, and I am not sure that I would want that extended to your Lordships' House for rather more junior Members of the Government. But clearly the Government have signalled that they are interested in the principle of hearings by appropriate Select Committees for certain very important public offices, and we will pursue that matter. I welcome his comments on freedom of information. Again, much effort will be made to engage noble Lords and Members of the other place in that matter.
	As regards House of Lords reform, in the light of the vote taken by the House of Commons and the work of the joint group, my right honourable friend the Prime Minister said at the Labour Party conference that the next Labour Government manifesto—whenever that is produced—would contain a commitment to the principle of election. There is much to be discussed between now and then and I look forward to all noble Lords taking part in those discussions and informing the work of the joint group.
	The new Local Government Bill, which your Lordships' House debated recently, and the concordat indicate that a much more grown-up relationship is developing between central and local government. The terms of reference and the timing for the Speaker's Conference are being discussed at the moment. I cannot tell noble Lords any more than that, but the details will be published shortly.
	On the voting system report, I am still sticking to the end of the year; we have some way to go. As far as what the noble Lord called "representative democracy" is concerned—he meant proportional representation and the political fortunes of the Liberal Democrat party—I remain a first past the post-er. Again, certainly in relation to discussions on reform of your Lordships' House, I have no doubt that we will have every opportunity to discuss these matters very fully.

Lord Lloyd of Berwick: My Lords, can the Minister can confirm the answer that I believe I got on the previous occasion when we discussed one of these wide-ranging essays on the governance of Britain, that the Government have no plans to involve the House of Commons, or Parliament as a whole, in the appointment of judges?

Lord Hunt of Kings Heath: My Lords, I think that is a very fair point. Clearly, in The Governance of Britain the Government signalled their wish to look at areas where authority could be moved from the Executive to Parliament, but in relation to judicial appointments the paper is clear in pointing out the risks of politicisation of that process. That is why the paper is careful to look at the options and does not show itself to be in favour of confirmatory hearings, which would accord with the concerns of the noble and learned Lord. I am very much interested in his views, and I think I can reassure him.

Lord Renton of Mount Harry: My Lords, I will refer to the point that I was going to make briefly earlier when the noble Lord, Lord Hunt, was speaking. I apologise if I was breaking the protocol of the House in interrupting him; I thought that I was in order.
	I would like to strongly take up the point that my noble friend Lord Kingsland made not just on consulting Parliament in the case of going to war, but actually seeing that the right information comes to Parliament first. I remember very well—I will never forget it—the debate in the House of Commons on whether we should effectively go to war with Iraq without waiting for the second United Nations decision or approval on that. I sat upstairs listening to the Prime Minister's remarks. I was swayed by the statement that Saddam Hussein and Iraq had weapons of destruction that could be launched within 45 minutes and that would have a radius that certainly enabled them to hit Israel, and probably to go a lot further. Because of that information, I told a great many people who I saw afterwards that, having listened to it, I was persuaded totally by the case; but as it turned out later that information was totally wrong.
	Like my noble friend Lord Kingsland, I have had no opportunity to read these documents; but surely the question of making certain that the right, fair and impartial information gets to Parliament before there is any question of declaring war is at the heart of the matter.

Lord Hunt of Kings Heath: My Lords, I, too, was present in the Gallery watching that debate, and the noble Lord will probably know that I resigned from the Government the next morning, so I am in some position to say to him that I very much agree with what he said. Clearly, in relation to these very serious decisions that Parliament is being called to make, it is important that Parliament has as much information as possible to make as wise a judgment as possible, commensurate with the need to balance the interests of Armed Forces, which may be in a vulnerable position, and more general security issues. I hope that when the noble Lord reads the consultative paper he will recognise that that matter is very much taken on board and will be subject to the consultation process.

Lord Goodhart: My Lords, like my noble friend Lord Tyler, I was particularly grateful to the Government for their decision not to press ahead with the very unfair proposals to increase to a very large extent the fees for applications under the Freedom of Information Act. Will the Government go a bit further than that and introduce a review of the Act? At the time of enactment, there was a good deal of dissatisfaction with the Act. Many of us felt that the Act was by no means as good as it should have been or as good as the Government originally promised in the first discussion paper on the subject. In particular, I am concerned about such matters as the ministerial power to over-ride decisions of the Information Commissioner. There are other defects in the Act. Therefore, are the Government prepared to consider a full-scale review of the Act?

Lord Hunt of Kings Heath: My Lords, first, I welcome the noble Lord's welcome of the Government's decision on fees. I make it clear that there was never any intention as a result of any change in the fees to hinder legitimate requests for information. In the Statement, and alongside it, we have announced that we are looking to extend the Act to organisations, particularly those bodies that have a relationship in one way or another with the public or with a public authority. I know that that will be warmly welcomed by many people. I cannot hold out hope for a fundamental review. The opportunity to extend the Act will be an opportunity for the Government and for all those who respond to the consultation to have an input into how we ought to take freedom of information forward in the future.

Lord Soley: My Lords, I thank my noble friend for repeating the Statement, which is very welcome, not least because the British constitution has been so successful over the years because we adjust it to changing needs; that is one of its great strengths. First, on intergovernmental organisations and treaties, the difficulty will be—as I am sure the Government are aware—that you cannot amend a treaty on the Floor of either House once it has been signed, so the process whereby we do that is very important. There are other dangers, as we discovered over a recent extradition treaty when the United States could not fulfil its part of the bargain because it could not get what the President had approved through either the Congress or the Senate—I cannot remember which. That is another area where we have to be very careful.
	On demonstrations, I readily acknowledge that the serious crime approach was the wrong approach. There is a point that has never been made as fully as it should have been on this issue. The Speaker of the House of Commons declares in each Session that exits and entrances to Parliament must be kept clear by the Metropolitan Police because of the recognition of the danger to democracy if people prevent their elected representatives getting into Parliament. That part of the equation has not received the publicity that it deserves.
	Finally, on the appointment of judges, it is not just politicisation that is the danger of examination in public, although I am not totally opposed to that. The other danger—which has happened to some considerable degree in politics—is that people cease to put themselves forward for such posts if they believe that their private lives will be crawled over in a way that would be unacceptable for them, their families, friends and relatives. We have to be aware that it is not just a politicisation issue; it is about the publication of the detail of people's lives when they go into public positions of this type.

Lord Hunt of Kings Heath: My Lords, I will respond to the last point first, as it is very important. In general, we need to get the balance right. We do not want to inhibit good people from coming forward; equally we want to make sure that there is public confidence in the way in which those appointments are made. We will seek to get the balance right.
	On the question of Parliament, the noble Lord put his finger on it. It is a very important principle that parliamentarians should have unfettered access to Parliament, as it is the right of our citizens to make protests. Getting that balance right is what was attempted in the Serious Organised Crime and Police Act 2005. There has been some comment that perhaps we did not get the balance exactly right and this is an opportunity to have another look.
	On the question of treaties, I understand what my noble friend is saying but, as I said to the noble Lord, Lord Kingsland, there are opportunities to discuss and debate the work leading up to the signing of a treaty. Also, because it is our practice to change domestic legislation before ratification of a treaty, there are many opportunities for parliamentarians to take part in those debates. The consultation paper poses a number of questions about placing Ponsonby in statute, about whether we need more flexibility and about whether the 21-day limit should be extended. What should be the exceptions to the rule? What should be the parliamentary procedure for triggering debates? Noble Lords will know that the noble Lord, Lord Lester, has brought forward Bills on this matter, which will no doubt be a guide to thinking in this area. What would be the outcome of votes? There are a lot of interesting questions, on which we would welcome views.

Lord Elystan-Morgan: My Lords, like many other Members of this House, I was a Member of the other place in 1972 when the European communities legislation was discussed. I well remember the wailing and gnashing of teeth on both sides of the House when it was discovered that the treaty was unamendable; not one syllable of it could have been changed. I appreciate that, in so far as public international law is concerned, no unilateral act by Britain can make a difference to that situation. We can change our domestic law and our domestic municipal arrangements. On the other hand, it is clear that the scope of creative involvement by both Houses of Parliament is extremely limited. You cannot, on the one hand, have Ministers who are plenipotentiaries—for that is what they are—eternally coming every day and night to Parliament asking for its consent. On the other hand, I agree that for there to be creative involvement for the sovereign will of Parliament there has to be something better than the present system, albeit on a limited plane.
	What is the status of the three documents referred to in the Statement? Presumably they are not White Papers. Presumably they are not Green Papers—they are not tendered academically with a view to having a general and broad discussion. Am I right in thinking that they are Green Papers with whitish tinges, giving some indication of the direction in which the Government are looking at these various and crucial questions?

Lord Hunt of Kings Heath: My Lords, I thought that the noble Lord put the matter very well, as he often does, in relation to treaties and the balance between treaties being unamendable, whereby parliamentarians do not feel part of any scrutiny process, and micromanagement in the sense of Ministers having to report on a daily basis. I come back to the point to which the noble Lord referred, that because domestic legislation has to be changed there is ample opportunity at that stage for both Houses to undertake detailed scrutiny. It is certainly the practice that Ministers regularly communicate with appropriate Select Committees, whose work I pay tribute to. Equally, I accept the point made by the noble Lord on "creative involvement", as he put it. I am sure that in this debate we will want to consider that. I am a bit reluctant to describe the document as green or white. I would say that it is mainly green. There are some whitish areas, but it is a genuine consultation and, when the noble Lord has had an opportunity to read it, he will find that many options are put forward.

Lord Goodlad: My Lords, does the Minister recollect that in the report to the House on the Green Paper, published on 20 July, the committee expressed reservations about the lack of reference to the role of the House of Lords in decisions about deployment of the Armed Forces overseas? The Lord Chancellor said in his evidence to the Select Committee yesterday afternoon, which the Minister may have watched on television, that it was his view that the House of Lords should debate the matter before the House of Commons. Can he confirm that that is the Government's position and that it will have more consistency than the announcements of the previous Lord Chancellor on this subject proved to have? Will he also confirm that this House and the judiciary will be consulted on all the matters in the Statement?

Lord Hunt of Kings Heath: My Lords, clearly we would very much welcome the contribution of the judiciary and Members of your Lordships' House in commenting on the details in the consultation documents. The noble Lord is right about what my right honourable friend said yesterday. The position of the House of Lords is set out in a number of areas in these documents and the Government recognise that the House of Lords has an important role to play, albeit within the context of Commons primacy. On war powers, my right honourable friend was suggesting—and the paper refers to this—that there might be a mechanism whereby the House of Commons would normally, where appropriate, allow some time for this House to debate a question, perhaps on a take-note Motion, before the Commons voted on it. That would be entirely consistent with our role as an advising and revising Chamber.

Baroness Miller of Chilthorne Domer: My Lords, I welcome the Minister's Statement on protests in Parliament Square. He will remember that this year I brought from these Benches a Private Member's Bill to discuss this issue. While I fully accept that access to Parliament is essential, I am sure that he will accept that in 20005 SOCPA completely changed the spirit of the protest. Will he assure me that in future it will not be necessary to get police permission for someone to demonstrate on Parliament Square when they are not blocking the roads or marching but simply standing there with a banner? Or is it the Government's intention merely to tweak the existing provisions?

Lord Hunt of Kings Heath: My Lords, that will depend on the results of the consultation and I very much welcome the noble Baroness's input into it. Noble Lords may be interested to know that between 1 August 2005 and December 2006 there were 17 convictions and one caution as a result of transgressions against the Act. However, 1,379 demonstrations with authorisation took place, with very few conditions imposed.

Lord Mackay of Clashfern: My Lords, in my understanding, one of the essential qualities of our democracy has been the integrity of the voting process. I confess to having been completely shattered by the result announced by the independent commission appointed to look into the situation regarding the Scottish elections last May. I would have thought that this was a constitutional renewal point most urgently needing the attention of the Government. It does not seem to be covered in any of these papers, green, white or mixed. I should have thought it absolutely essential that this be looked at very quickly and thoroughly in order that this kind of doubt is not cast on the integrity of the voting system in any future election for either the United Kingdom or any of the devolved Parliaments or Assemblies.

Lord Hunt of Kings Heath: My Lords, the noble and learned Lord is right to suggest that the integrity of the voting system is critical to our democracy and to the public's confidence in our democratic institutions. I assure him that all questions in relation to that and to electoral administration are being fully considered. The noble Lord, Lord Tyler, has already referred to the review, which will be published at the end of the year. Of course, we have not yet seen the terms of reference of the Speaker's Conference but it is entirely possible that it will wish to look at issues of electoral administration.

Police Reform Act 2002 (Standard Powers and Duties of Community Support Officers) Order 2007

Lord Bassam of Brighton: rose to move that the draft order laid before the House on 8 October be approved.

Lord Bassam of Brighton: My Lords, the order before your Lordships' House introduces a list of standard powers for police community support officers and has already been approved in another place. The order will take effect from 1 December this year and all chief officers of police in England and Wales will be required to ensure that PCSOs are suitable, trained and competent in these areas.
	The Secretary of State is able to introduce, by order, standard powers and duties for PCSOs but is required, first, to consult the Association of Chief Police Officers, ACPO, and the Association of Police Authorities, the APA. I am sure that noble Lords will be pleased to note that, given the interest in this subject, we decided to extend the statutory consultation to include also the Police Superintendents' Association, the Police Federation, UNISON, the Public and Commercial Services Union and the Transport Salaried Staffs' Association. Noble Lords will also notice that the list of powers included in the order reflects the views expressed during the passage of the Police and Justice Bill.
	We listened to the comments and, in considering the final list of powers to be included, sought to strike an appropriate balance between the need to maintain the largely non-confrontational, community-engagement role of the PCSO and the need to ensure that all PCSOs are provided with a robust set of powers that will enable them to contribute most effectively to neighbourhood policing and deal with low-level disorder and anti-social behaviour.
	I am aware that, during debate on the Police and Justice Bill on this subject, some Members of the Opposition were concerned about the centre directing and governing the activity of the police. I stress that operational decisions about the deployment of PCSOs must, rightly, be left in the hands of chief police officers. However, there has been clear support from both ACPO and the APA for the introduction of a standard set of powers for PCSOs. They have been concerned about how the disparity in the extent to which PCSOs are designated with powers from force to force has lead to public confusion over their powers and role.
	There is support for standard powers, and noble Lords will be reassured to know that the statutory consultation that took place earlier this year showed that there is also a consensus on the content of the list of standard powers.
	The consensus around what powers are appropriate is also reflected in the extent to which most forces are already using the powers included in the standard list. The audit of powers designated by force, which was completed by the Home Office and ACPO and published on the Home Office PCSO web page in May this year, showed that, at that stage, 10 of the 20 powers proposed as standard are already designated in over 85 per cent of forces and that a further five powers are designated in over 70 per cent of forces. In fact, more than a third of forces already designate all the powers on the standard list to some or all of their PCSOs. Significantly, those 15 forces represent more than half the strength of PCSO numbers in England and Wales.
	We are pleased with the extent to which forces have already introduced the powers included on the standard list. However, this order will ensure that the public can be confident that all PCSOs in their area are appropriately empowered to deal with issues that have a detrimental impact on the safety and security of their communities.
	The value of PCSOs is found not just in their ability to deal with issues on the street; a key element of their role is in providing visible reassurance and a familiar face that understands the concerns of communities. They act as the eyes and ears of the police service in the heart of our communities, and that vital role should not be underestimated. The fact that the PCSO is attracting a broader representation of our society in terms of age, race and gender is also very welcome, and it has no doubt helped police community support officers to win the confidence of the diverse communities that they serve. This dual approach to engagement and enforcement is key to the successful delivery of neighbourhood policing.
	Noble Lords will, I am sure, be aware of the Government's commitment to working with the police to ensure that a dedicated neighbourhood policing team is in every area in England and Wales by March 2008 providing high-profile, community-focused policing. As part of that commitment, we have provided the resources to enable police numbers to reach record levels. The police family has never been bigger and we have an historic number of sworn police officers. Although PCSOs are not, and never will be, a replacement for fully sworn constables, they also have an important role to play as part of the policing family. Our work with the police on a nationwide recruitment drive has already seen the number of PCSOs achieve the target of 16,000 set for April 2007.
	Taken together, these measures mean that we are seeing an ever-increasing presence on the street, deterring crime and reassuring communities, and we see the introduction of the standard powers for PCSOs as a means to further enhance the already positive impact that they are having in our communities. I beg to move.

Moved, That the draft order laid before the House on 8 October be approved. 27th Report from the Statutory Instruments Committee.—(Lord Bassam of Brighton.)

Viscount Bridgeman: My Lords, I am grateful to the noble Lord, Lord Bassam, for tabling this Motion. It does indeed address an important issue and I welcome the Government's attempt to make a step in the right direction by introducing the order.
	However, in the opinion of this side of the House, it does not yet constitute a big enough step. I appreciate the Government's efforts to try to codify formally the basic duties and standard powers that are open to police community support officers and I am grateful to the noble Lord for describing the balance between centralisation and localisation in this respect, but, if we are truly to maximise the effectiveness of this force, greater clarity is still needed. As an example, PCSOs in Bedfordshire do not have the power to search detained persons for dangerous items, while in neighbouring Hertfordshire they do. In Leicestershire, PCSOs have the power to disperse groups of people under 16 years old; in Lancashire, they do not. Indeed, as was mentioned in another place in reference to the matrix, published in May and outlining PCSO powers as designated by the respective constabularies and police force areas, out of the 44 areas listed in England and Wales, at first glance, no two forces seem to have the same spread of the 59 designated powers. We on these Benches welcome the positive step introduced by the order towards standardising and codifying these powers but feel that it only scratches the surface of what could be done to make PCSOs a more efficacious force.
	The effect of that lack of clarity is a concern in terms of the impact on the British public and community support officers themselves. In order for PCSOs to operate effectively—indeed, to provide the security and increased sense of safety that they were created to provide—more of an effort needs to be made to ensure that they are respected. Greater continuity in the capabilities that these officers possess would go much further to ensure that they receive this support. An article in the Times by Libby Purves, addressing the more controversial point about PCSOs' uniforms, points out:
	"At the moment the public are entitled to be irritated and confused. If it looks like a duck and quacks like a duck, it ought to be able to peck like a duck".
	The problem with these orders is not so much looking and quacking like ducks but that we do not know which ducks can peck and which cannot. Knowledge among those committing offences of the discrepancies of the powers could begin to stir up disrespect and indeed resentment. The offensive labels some have given these officers—"plastic policemen" and "glorified traffic wardens"—are unfortunate precisely because PCSOs are obviously much more than that. I sincerely hope that this statutory instrument will go some way towards recognising the important position in the community that these officers occupy.
	Greater clarity helps PCSOs to have greater understanding of their objectives and to be able to achieve them as effectively as possible. Thus, the intention behind this statutory instrument—to set a minimum standard—is certainly welcome, but there remains far too much subjectivity and inconsistency across the force as a whole. I encourage the Minister to review PCSOs' designated powers with all interested parties, and I am grateful for his clarification that this was a widespread consultation. I hope that we will see the emergence of a common set of powers and responsibilities throughout the country in the near future. I look forward to the Minister's response.

Baroness Miller of Chilthorne Domer: My Lords, I thank the Minister for explaining the order and giving the Government's view on it. Notwithstanding the good description of the duck given by the noble Viscount, Lord Bridgeman, the policing family seems never to have been larger. We support that and the added capacity provided by PCSOs, but never has the policing family been more confusing to the public. There are regulars, PCSOs and specials, and it is difficult for the public to understand whether the police have enough powers—when a police officer says "No, I'm not able to deal with that, it's not within my powers"—or too many; I refer, for example, to when they are stopped and searched. How are the public to know whether that is within the power of the person who is stopping and searching them? My noble friend Lady Harris was consistent on this in response to the 2005 consultation paper Standard Powers for Community Support Officers and a Framework for the Future Development of Powers. She and other policing stakeholders expressed concerns at proposals to include powers to detain and to increase PCSOs' law-enforcement capabilities, but we recognise that we have moved on from that battle. The standardisation of powers does not stop chief constables giving PCSOs top-up powers should they deem them necessary. When the Government first introduced PCSOs, the idea was that they should be targeted particularly at anti-social behaviour and at providing a visible presence. Giving them powers under the Terrorism Act 2000 to seize vehicles and to search for drugs does not seem to fall within that remit, which seems to be being widened considerably.
	How does the Minister believe that the public should be able to distinguish the different members of the police family? As the Government introduce standard powers for PCSOs, it is important that they address that issue so that the public and communities can have a clear understanding, not just in theory and print, but on the street. Finally, will the Minister comment on whether chief constables are given responsibility for ensuring that PCSOs are completely trained and are capable of carrying out their functions before they are given the increased minimum standard powers?

Lord Bradshaw: My Lords, I am a member of the Thames Valley Police Authority and have been for a large number of years. I have also been a member of the Association of Police Authorities. I have two vital points to raise with the Minister. First, police community support officers are supposed to be outside the police station and visible to the public for most of their time. That is not the case with police constables, sergeants and higher ranks who are burdened with paperwork and sit in their offices, staring at computers, rather than being out on the street. Anything that extends the powers of police community support officers should not mean that they go back in the office so that the public cannot see them because, despite what my noble friend just said, people want to see a police presence and I am not convinced that people easily distinguish a police constable and a police community support officer. I know that all police community support officers have radio contact with forces to back them up should they get into any confrontational position.
	My second point is a major issue that I trust the Minister will take back to the Home Office: it is the funding of police community support officers. At the moment, they are living on almost year-to-year funding, and it is difficult to recruit and retain people in a job when police authorities are by no means confident that the money to pay them will be forthcoming. These issues may be over and above the one that we are debating, but they are worth raising for the Minister to take back.

Lord Bassam of Brighton: My Lords, I am grateful to the noble Viscount, Lord Bridgeman, the noble Lord, Lord Bradshaw and the noble Baroness, Lady Miller, for their contributions, and I am grateful to the first two speakers for their support for the clarifying powers in this order because we need to ensure that there is clarity. I alighted on the plea made by the noble Viscount, Lord Bridgeman, for greater clarity. He is right that we must address that not only in this order but also in future as the police community support officer system develops. It is still in the process of development. We were opposed by both parties at the outset of our journey towards developing the role of police community support officers, but both opposition parties seem to have come round to support the idea to a greater or lesser degree, which is welcome.
	Police community support officers are now a well established part of the policing family, and the public have come to like, trust and respect them. When I was thinking about this order, I asked a number of questions of the officials advising me to flesh out my understanding of how the system has bedded down and works. I was pleased to hear that not only are PCSOs accepted within the policing family and seen as doing a valuable job, but there have been relatively few complaints about the way in which they have gone about their work. The public seem to like them because they can see that they have a distinct role and are dealing with the low-level disorder that many of us run into from time to time—I certainly do and I am sure that other noble Lords do too. In my interaction with PCSOs, I have always found them incredibly helpful. I have no problem identifying a police officer and a police community support officer as they are badged very differently. The PCSOs I see have great big stickers on their backs telling you who and what they are. You cannot really make much of a mistake with that.
	The other thing that has pleased me about the PCSO programme is the way they work with police officers. To pick up on a point made by the noble Lord, Lord Bradshaw, I think that they have taken away a lot of the burden that was there and freed up time for more complex policing operations, and they have provided that necessary reassurance and presence on the streets. The programme is a very useful addition and supplement to the way the policing service has been developed over the past few years.
	I undertake that when we review, as we will continue to review, the designation of powers, we will look again at the important issue of clarity. I take very seriously the issue raised by the noble Viscount, Lord Bridgeman, about the different use of PCSO powers in one police force area to another. In a sense, that is why we have introduced this; so that we get a level playing field across the piece to a greater extent. I must say that one should respect the command operation in each police force area and, of course, chief constables will know better what is needed in their police force area and will want to use PCSOs in a more focused way and for different purposes. Obviously not every police force area is the same and has the same sorts of pressures.
	I have dealt with the issue of confusion. There is careful badging of PCSOs and most people have managed to grasp the difference, and the difference in duties and responsibilities. As I have just reflected, in some police force areas chief constables will want to use their PCSO service differently. The big emphasis for most people is in tackling anti-social behaviour, and they have made great strides in that. The neighbourhood policing programme is benefiting already from the work of PCSOs, and will carry on doing so.
	I pick up on the important issue of training. Of course training has to be undertaken before PCSOs embark on the exercise of their new powers and responsibilities. Chief constables are charged, in general terms of course, to make sure that that happens. I am advised that most forces are planning to carry out additional training by 1 December. In any event, chief officers must carry out this training within a reasonable period of time after 1 December, so that PCSOs are properly trained before they embark on their duties.
	The issue of funding was raised, and I can understand that there may be some concerns about that. The noble Lord, Lord Bradshaw, made the point that there is a year-to-year hand and mouth issue here. The funding will not come to a conclusion when the neighbourhood policing programme ends next year. The programme will go beyond then. That was an initial date. Neighbourhood policing is not an add-on as far as we are concerned, nor is it an optional extra; it is an integral part of policing, and, as I said earlier, it is what people want. We remain committed to ensuring that it is firmly embedded in the core of policing, and we will sustain our investment beyond 2008. In due course we will put the funding into the general policing grant so that the resources will continue to be available in the longer term. That is a very important commitment.
	I think that I have answered all the points raised. If not, I apologise to your Lordships' House. There was the issue of PCSOs doing some anti-terrorist work. I think that is right; it is a sensible use of their time. Clearly, one would expect—from our understanding of the way in which these lower-level powers operate—that they are taking some of the more routine work away from police constables so that they can concentrate on the major part of any terrorist event that might have taken place. I am sure that PCSOs will work very carefully with constables in exercising stop and search powers, and, where it is necessary—and I am sure we would accept that it would be necessary in some circumstances—the seizure of vehicles.
	I am grateful to noble Lords for their interest, support and questions. I am also grateful for the fact that we have now moved on with this debate and that there seems to be a much broader base of support for the development of PCSOs as part of the police service.

On Question, Motion agreed to.

Housing Benefit (Loss of Benefit) (Pilot Scheme) (Supplementary) Regulations 2007

Lord Kirkwood of Kirkhope: rose to move that an humble Address be presented to Her Majesty praying that the regulations laid before the House on 29 August be annulled (SI 2007/2474).

Lord Kirkwood of Kirkhope: My Lords, I am grateful to the Minister and to noble Lords on both sides of House for taking an interest in the debate. I say at the outset that I have no intention of dividing the House, which will probably not come as a surprise to many people. The purpose of tabling this Prayer was that I was minded to divide the House. The condition the Minister has now expunged and met is that the full guidance is now available in the public domain and to the stakeholders. These important pilots appeared as if by magic in my inbox this very morning. So, to that extent, I am satisfied.
	It is important—and I am sure that the Minister will agree—that the guidance should be made available. These pilots start on 1 November and everyone should know how these things are to be played through. And I am grateful for that. In parenthesis, and at the risk of being boring because I say this nearly every time we have an exchange with the Minister, I understand that the Government have to get the business through, but I, for one, would have been very much happier had I seen a formal reference to the SSAC. The Social Security Advisory Committee of course cannot take formal references on statutory instruments that flow within the six months of the passage of primary legislation. These pilots are quite contentious in a number of different ways, and I would have been happier if the SSAC, with its depth of knowledge, had been able to opine on this and give the House the benefit of its collective wisdom before the legislative process, which finishes this afternoon, was completed.
	This is the last chance for us to have a debate about this matter. It is not, obviously, the time to go into all the background principles and fundamental concepts behind the policy objectives. We have had those debates. We had a very good debate on the Welfare Reform Act, Section 31 of which spawns these regulations. That Act is a welcome piece of legislation. I think that the Government are perfectly reasonably able to found on these pilots. Valuable lessons can be learnt in the 10 areas in which they will obtain for the next two years. The pilots are for a limited period of two years. The areas are geographically restricted to England at the moment. So-called "former occupiers", in the Queen's English, really means evicted tenants, but I will let that pass. The small number of people affected and the ultimate sunset clause of 31 December 2010 are welcome safeguards. We recognise that. Speaking for myself, I think that that is the least the Government can do.
	The Government can also perfectly reasonably found on these pilots, dealt with in these regulations, an important aspect of the respect agenda. The respect agenda is a common cause on all sides of the House. It is a terrible title, very Daily Mail—and anything to do with the Daily Mail gives me the heebie-jeebies. Notwithstanding that, the policy objectives behind trying to get people to be more responsible in their behaviour to their neighbours and the environment in which they live is absolutely right. I just do not think that the benefit system, and using sanctions in the benefit system, is an acceptable way to do that. Indeed, I think that the stakeholders and the Government deserve credit because there has been substantial consultation, and that consultation has produced a lot of extra safeguards. Perversely, they are making the guidance more lengthy and complicated. But it is all to the good because it is all to try to get better safeguards for the people to whom these pilots may apply.
	I hope that the Minister will understand that one of the key elements that we will apply when watching the outcome and development of the pilots is the extent to which they—by a process of osmosis, almost—introduce behavioural tests into eligibility for social security or housing benefit payments. If we start to go down that road, it will be deeply worrying. We started off in the old days with national insurance contributions producing benefit payments as a result. As the system has developed, it has become more means-tested and more targeted. Therefore, the eligibility for benefits is down to domestic household income. Those should be entitlements with a capital 'E'. As soon as you introduce any other test by way of behaviour—which is a very difficult thing to define—there are real causes for concern. People's rights and entitlements under the benefits system may be confused and diluted if we go too far down that route.
	I say again that laws that are restricted to apply only to people who receive a single type of benefit are deeply questionable. That is another thing that we will need to watch very carefully in the course of the pilots.
	Complexity is an even bigger issue, for the very good reason that there are yet more safeguards, which we welcome. The Government have, through the consultation process, found new ways to protect people. That is good, but you pay a price for that in increased complexity. I have not yet had a chance properly to read the notes and guidance in great detail. People obviously benefit from increased protection, but that makes the system more complex. We will be watching that very carefully over the next two years as well.
	Another continuous gripe that I have in social security debates is that we often forget that benefit deductions can be insidious. They pop up here and there and we do not take account of them. We think that all families are starting with a common level of income because they are on minimum benefits—even minimum benefits cause problems for people who try to live on them. They are a challenge to domestic budgets in some parts of the country. If some, whom we then forget about, are then subject to deductions of one kind or another—this is not a unique deduction, but it is yet another deduction—that may produce hardship in a way that is not easily seen.
	I still think that prevention is by far the best policy, as demonstrated by some of the evidence given by stakeholders. It would be useful if the Minister could say a word about what the Government will do during the two years when the pilots are in place to ensure that there is a network of rehabilitation support throughout England, so that we use that time to ensure that if the pilots in the 10 areas are rolled out more extensively, rehabilitation support services will be available for anyone who falls into the realms of the legislation. I am sure that the 10 areas were selected because they have rehabilitation services available, but, as I understand it, if we were to roll out the legislation and there were no rehabilitation services to hand, the legislation would fall, because local authorities cannot sanction people if they are not invited to use existing services.
	I sense that the money could be better used. I accept that there have been welcome developments in added protection. I must say that the good-cause provisions in Section 5 look very much as if they have been cut and pasted from jobseeker's allowance, which takes us back to the wonderful prospect of good-cause circumstances including, among others that you could plead for avoiding the regulations, the manning or launching of a lifeboat. I will give the Minister a new Scots £10 note for every time that good cause could successfully be prayed in aid during the next two years. That is a no-lose bet for him and, coming from a Scotsman, that is very unusual.
	There are genuine concerns. The Government have gone some way to meet some of them—that must be acknowledged. I still think that the pilots are daft, but I am prepared to be persuaded. I conclude on this. I am sure that colleagues in the House on both sides will be watching the pilots like a hawk. If they slipped without further discussion into a major roll-out throughout the rest of the United Kingdom across the whole housing benefit system without very careful evaluation, we could store up problems for ourselves in future.
	On those grounds, I beg to move the Prayer to Annul the regulations on the basis that if the Minister gives us some steer as to how he will proceed, I will not test the opinion of the House.
	Moved, That an humble Address be presented to Her Majesty praying that the regulations laid before the House on 29 August be annulled (SI 2007/2474).—(Lord Kirkwood of Kirkhope.)

Lord Skelmersdale: My Lords, somewhat unusually, listening to the noble Lord, Lord Kirkwood, a remark of Flanders and Swann in the early 1960s—those magnificent satirists, alas, no more—sprang to mind. I remember that, "O tempora, O mores!" was translated as, "O Times, O Daily Mail!" on the London stage.
	Be that as it may, in the unavoidable absence of my noble friend Lord Taylor of Holbeach—he has, after all, been following this saga throughout—I am very pleased to be able to speak in support of the noble Lord, Lord Kirkwood, on the regulations, which supplement the Government's continuing insistence that it makes sense to have a series of pilot schemes allowing the partial or, at worst, complete withdrawal of housing benefit for anti-social behaviour.
	That we should condemn such behaviour and, as a legislature, draw up laws to minimise it should, as the noble Lord just said, go without argument. We have that right and I agree with the Government that that is our duty. But with rights and duties go responsibility, and responsibility means that we must draw up laws that are appropriate to the problem that they seek to address. The problem undoubtedly exists. Anti-social behaviour is a curse of society. Not only does it "ruin lives", as the Minister said in July, but it can make already sick people more ill, as happened to my son-in-law—but more of that anon. It is arguable, however, that anti-social behaviour creates an environment in which serious crime can take hold, as the Minister also claimed at the time. Whether his estimate of a £3.4 billion cost to the taxpayer is right, I cannot say, but I have no doubt that its knock-on effects cost us all a thundering lot of money.
	The 2006-07 British Crime Survey showed us that the problem is getting worse. The proportion of people perceiving high levels of anti-social behaviour in their local area has risen by 1 per cent in the past year to 18 per cent. However, the regulations, and the original order that they hang on, address only part of the problem, as between them they apply only to people who have already been ejected from one house or flat for anti-social behaviour and are in danger of being removed again for the same reason. They thus apply to a rather limited number of people. I note that among the myriad of modern Home Office legislation, a new power was introduced on 2 October last year allowing the police to apply for intervention orders to try to deal with the anti-social behaviour of drug users. That may be one reason why the householder was ejected the first time round.
	The noble Lord, Lord Kirkwood, touched on the fact that when we originally debated Clause 31 of the Welfare Reform Bill, as it was then, in early March, I interjected that the sanction of withdrawal of housing benefit was referred to in the housing Green Paper of 2000. That Green Paper was at best lukewarm about this idea, commenting that it would be difficult to use the sanction on a claimant guilty of anti-social behaviour without it impacting adversely on innocent members of the household. The scheme was soon vetoed by the then Deputy Prime Minister, Mr Prescott, but, as we all know, it raised its head again in the Welfare Reform Bill earlier this year. The Bill originally proposed that local housing authorities would be allowed to use it anywhere in the country.
	During the passage of the Bill, the Government and opposition parties received adverse representations from the charities concerned and some of the local authorities which were to operate the scheme. What surprised me was that DWP Ministers started saying that they hoped that the sanctions would never be used. That is almost a direct quote from the noble Lord, Lord McKenzie of Luton. He will remember that on that basis, I argued that we should not have it at all. However, in the spirit of compromise that I hope I often exhibit, I was happy to allow a pilot scheme to go ahead as long as it had a limited life and, if the pilots were successful, there would be further primary legislation to roll out such a scheme across the country. That is the position we find ourselves in today.
	The original order, which this one supplements, was debated in July this year and provided for pilots to be set up in eight local authority areas: Blackburn and Darwen; Blackpool; Manchester; Newham; Wirral; Dover; New Forest; and South Gloucestershire. My first question to the Minister is whether they are still all on board or have any of them exhibited the cold feet anticipated when my noble friend Lord Taylor debated the primary order with the Minister in July? I observe that only the first five have family intervention projects in place. Should they find that, because of that, they do not need the sanctions, how will that help the evaluation of the pilots?
	The original order was rushed out fairly quickly after the Bill received Royal Assent; we were told in the Explanatory Memorandum that this supplementary order would be necessary to make these pilot schemes work. What has happened to the care and attention to detail that the DWP's predecessor departments exhibited 20 years ago, when we would have had slower, but more complete, details in a single order? That order would only have needed to be supplemented in the light of experience—experience which the Minister will be forced to agree we cannot have because the pilots only start on the 1st of next month. Does he agree with my anticipation of at least one further supplementary order some time next year, when that experience will have started to be gained?
	Almost a year ago, the Government's respect tsar, Louise Casey, announced that 40 areas in England and Wales are to be offered additional funding to become respect zones. In return, these areas are expected to use their full powers to combat anti-social behaviour. Full powers must include the powers in these two orders—at least, I assume they do; perhaps the Minister can tell me. Are all the eight pilot areas in the respect zones? If not, why not? Or is it another case of one department not knowing what another is up to?
	To change the subject, these pilots ought to come to a grinding halt on 31 October 2009, the two years agreed in the compromise. Why, then, does paragraph 7.4 of the Explanatory Memorandum say:
	"The intention is to pilot the scheme for 2 years in eight local authorities"?
	So far, so good. It continues:
	"These regulations only apply to the pilot areas".
	Again, so far, so good. It goes on to say:
	"The enabling power is time-limited and will come to an end on 31 December 2010. For a scheme to be in place after this date primary legislation would be required".
	Does this mean that the pilots will not actually start until well into next year? What exactly does it mean?
	Then there will be an evaluation and we will be able to see whether my scepticism is borne out in reality. But the noble Lord, Lord Kirkwood, is right that at the start of these two years it is the guidance, which should by now have been sent to local authorities trialling this scheme, that is all-important. I am remiss in not having asked before, but I would appreciate a copy—the noble Lord has clearly had one. Either I have not been at my desk recently or I have not been sent one automatically. That is not a complaint. This is one of the many occasions on which one should ask for that information from the department.

Lord Kirkwood of Kirkhope: My Lords, it is not great weekend reading.

Lord Skelmersdale: My Lords, I rather think that my activities in the House next week will mean that I have 10 days in which to read it, rather than a weekend.
	As I said earlier, we all condemn anti-social behaviour. My daughter experienced it some years ago in Sheffield. It took a little time to persuade the youth next door to stop playing loud music at all hours, but the matter was eventually settled through the good offices of the environmental health officer, without—and this is the important point—the withdrawal of housing benefit. None the less, the experience made my son-in-law's illness worse for a considerable period thereafter. Is not this the point? Will the mere threat of withdrawal be enough to stop bad behaviour, or will sanctions actually have to be employed? Which of these two would the Minister raise as a successful outcome to the pilots? Once we know that, we will be able to make our own evaluation. In the mean time, like the noble Lord, Lord Kirkwood, my scepticism remains unabated.

Lord McKenzie of Luton: My Lords, I thank the noble Lord, Lord Kirkwood, for giving us the opportunity to have another debate on this issue. I am conscious that both he and the noble Lord, Lord Skelmersdale, are not very keen on these proposals, but I hope that we have a shared objective as they are to proceed in making sure that they are dealt with effectively and sensitively.
	Before I start to deal with some of the detailed points, I remind the House of the wider context of the regulations. As has been acknowledged, anti-social behaviour ruins lives and creates an environment where more serious crime can take hold. Anti-social behaviour is estimated to cost the British taxpayer £3.4 billion a year; even if that figure is subject to challenge, it is acknowledged that a lot of money is involved.
	We are determined to stamp out anti-social behaviour. The respect programme is delivering an approach that tackles and prevents damaging behaviour, for example, through additional investment announced earlier in 2007 for extra parenting provision. In April 2007, we announced that we have delivered on the promise to establish a network of 53 flagship family intervention projects. That deals in part with the point of the noble Lord, Lord Kirkwood, about what happens if we rolled this out across the country.
	The housing benefit sanction is part of this overall approach but only part; it is one of many tools that we have given to local authorities at the front line in dealing with anti-social behaviour. The aim is to provide a strong incentive to encourage households where a person is evicted as a result of anti-social behaviour to undertake rehabilitation when they have refused other offers of help. As we know, this measure was thoroughly debated during the passage of the Welfare Reform Act 2007, so I know that there are concerns, particularly at the impact of this measure on vulnerable people. However, this is about helping people in crisis to accept support offered to them. Because they have already been evicted, the chances of it happening again are high unless they change their behaviour.
	As I have said before, and I repeat today, this policy will be considered a success if no sanction is imposed. That will mean that people have accepted the help that we believe they need. We know that intensive rehabilitation can achieve positive and significant changes in behaviour, resulting in longstanding difficulties and entrenched anti-social behaviour being stopped. In previous debates I have set out in detail the supporting evidence. Given this strong evidence that such rehabilitation works, it is justifiable that a sanction of benefits should be linked to the refusal of such help and support. The fate of those who have a sanction imposed is in their own hands. Benefit will be reinstated if they choose to take up the rehabilitation services offered to them.
	This summer, we debated the regulations that provide for the pilot scheme, and the pilot will run for two years, starting from 1 November 2007. The noble Lord, Lord Skelmersdale, referred to another date in the Explanatory Memorandum. I suspect that that was the final date by which pilots had to be completed and was the date at which the sunset clause kicked in. I will look at that and write to the noble Lord if it is other than I have said.
	The debate in the summer approved the essential elements of the scheme, and the regulations set out in more detail the rules on how the sanction will work, for example on good cause and information sharing. They do not contain any new provisions. I am pleased to say that my department has been working closely with the eight local authorities that have volunteered to test the measure. There are indeed eight, and I can tell the noble Lord, Lord Skelmersdale, that they are all still on board and actively engaged. They have the necessary procedures in place and are ready to start the pilots on time.
	Detailed guidance has also been developed, as we have heard, for housing benefit administrators, the courts and local authorities. I am sorry if that guidance was not issued a long time before the opportunity for this debate arose, but it has just been finalised. It is draft guidance, because it is anticipated that they will learn from the pilots and that there may be the need to revise the guidance in the course of those pilots.

Lord Skelmersdale: My Lords, I asked whether the Minister anticipated another order, or will the revision of the guidance, should it be necessary, be sufficient?

Lord McKenzie of Luton: My Lords, I am not aware that another order is in the offing or anticipated. I stress that we are dealing with pilots, and the flexibility that they present should be borne in mind, but it is quite possible that the guidance will be adjusted in the course of them.
	I stress that the guidance has been drafted with the pilot authorities and relevant stakeholders, including those who represent vulnerable people. The noble Lord, Lord Kirkwood, referred to extensive consultation, which is right. We know that a number of stakeholders are not particularly happy with the direction of this policy, but they have engaged with us and, within the context of what is happening, they are content with the guidance. We are reassured by that.
	I am satisfied that the guidance is balanced and encourages those considering whether to sanction to take all circumstances into account in a sensitive way. The guidance sets out, for example, that a multi-agency approach should be adopted when a decision is being taken whether to sanction. It is envisaged that in most cases decisions whether to sanction will be made by a panel of key professionals and support workers. The guidance acknowledges that, with a multi-agency approach, some agencies may support the use of the sanction but others may oppose it. If this is the case, there will need to be a clear separation between assessment and decision. In determining whether a sanction should be imposed, the following should be taken into account: the circumstances of the household and the impact that a sanction is likely to have; previous support provided and the impact on the household's behaviour; efforts made to engage with the household and the response; details of support available to the household and when it is available; whether the individuals know and understand that a sanction may be imposed and what this will mean in practical terms; and the likelihood that a sanction will bring a desired change in behaviour.
	Members of the household should be given the opportunity to explain why they will not engage and whether any circumstances should be taken into account. They should also be asked about the impact of the sanction on their ability to secure adequate housing, their physical and/or mental health, and their ability to maintain education, training and work. When doing this, the local authority should take into account literacy, language and communication skills if, for example, face-to-face contact is the best way in which to engage with the person. The guidance sets out detailed steps to be taken in dealing with vulnerable people, particularly those with mental health issues, physical and sensory impairments, learning difficulties and drug abuse issues. I have placed a copy of the guidance in both House Libraries and sent it to noble Lords on the Front Benches.
	On the more specific points that have been made, the noble Lord, Lord Kirkwood, referred to the SSAC. It was consulted informally on the draft regulations and made its view clear. There has been extensive consultation, as we have said. The noble Lord is right in a sense in that any proposal that seeks to safeguard people and ensure that a provision is fair could add to the complexity; we see that in so many areas of government policy, not least in taxation policy, which we debate from time to time. The number of areas is eight, not 10. The noble Lord was also right that there can be no sanction if the relevant services are not available. That is very clear from the guidance and from statements that we have made on a number of occasions.
	The noble Lord, Lord Skelmersdale, asked how many of the pilots had family intervention projects and instanced five. That is right. Part of the benefit of the pilots is to see what happens in other areas with mechanisms other than formal family intervention projects. I was also asked how many pilots are being held in respect zones. I think that three are. One is being held in London, which has no respect areas. Respect-area status was for the most active areas, so they are not all in respect areas. We have dealt with the point that not all pilots have FIPs. The noble Lord, Lord Skelmersdale, asked whether we thought that this would be a success and whether the sanctions would be used. The best outcome would be if they were not used, because that would mean that they were acting as a deterrent and were encouraging people to engage with the support that is on offer. That is particularly what we want. The noble Lord also asked about innocent members of households. This issue was also raised by the SSAC and is very much part of the judgment that a court would make, because the process is triggered in the first instance by a possession order due to anti-social behaviour. Obviously a range of circumstances would routinely be taken into account.
	I hope that I have dealt with most of the issues that noble Lords have raised. I am very happy to try to answer further questions if I have not. The sanction is not intended to be widely used, but it will provide another way for local authorities to help families in crisis to obtain the support that they need. I am comforted that the noble Lord, Lord Kirkwood, is not intent on pressing the Motion to a vote, but I appreciate the opportunity to debate this policy matter with both noble Lords.

Lord Kirkwood of Kirkhope: My Lords, on the basis of that reassuring response from the Treasury Front Bench, I think that the Government understand that the House will be watching these pilots very carefully. Given the Minister's assurance that the Government will keep us advised of developments as the pilots unfold, I am perfectly happy not to press the matter to a vote. I beg leave to withdraw the Motion.

Motion, by leave, withdrawn.

NHS: Osteoporosis Services

Baroness Quin: asked Her Majesty's Government what steps they are taking to improve osteoporosis services within the National Health Service.
	My Lords, I welcome this opportunity to raise in the House the issue of how the National Health Service currently diagnoses and treats osteoporosis. I also welcome the fact that a number of colleagues who take a keen interest in this subject are present; I particularly welcome the presence of the noble Baroness, Lady Cumberlege, who chairs the All-Party Parliamentary Group on Osteoporosis.
	I have no direct interest to declare, so I will begin by explaining how I first became interested in this issue. When I passed the landmark age of 60—a not unusual experience in this House—my GP said that she would have ideally liked me, in common with a number of her patients, to have a bone density scan, but that unfortunately the DEXA scanning facilities were not available in our area. As a result, I became interested in the availability of such scanning facilities. Through Parliamentary Questions, I became aware that the provision of DEXA scanners seems to be yet another example of the postcode lottery that we hear about and that provision is inadequate and patchy.
	I realise that routine scanning—say of all women over 60—is not the best way forward, but what particularly concerns me about the current situation is that women and men who are at risk of developing osteoporosis are not being systematically identified and offered scanning or other osteoporosis services on anything like the scale needed. It is true that the Government have increased funding for DEXA scanners, but not to the extent required for good provision throughout the country. Neither was the money for scanners ring-fenced; in Answers to Parliamentary Questions I was unable to get any reassurance that all the money had actually been spent on scanners.
	I am also concerned that, as I found from Answers given to my Parliamentary Questions and to those tabled by Members in another place, the department seems to hold so little information centrally on the availability not only of scanners but of other osteoporosis services throughout the country. Given that the Minister and the department are committed to improving services in this area, it is regrettable that so little information about what is actually happening on the ground is currently being collected or assessed at national level.
	Although my initial contact with the issue of osteoporosis arose from the specific problem relating to scanners, I have since become interested in the wider question of how effectively osteoporosis is diagnosed and treated throughout the country. I would like to say how grateful I am to the National Osteoporosis Society, whose briefings and expertise have been a huge help. I am also grateful to the other organisations that have shown an interest in this debate, including Help the Aged.
	There can be no doubt that osteoporosis is a very important issue for the NHS. It is said to affect as many as one in two women and one in five men in the UK. Although it principally affects older people, we must remember that, in a society like ours where life expectancy and the proportion of older people have increased, it is very significant. The National Osteoporosis Society has calculated that the combined cost of hospital and social care for patients with a hip fracture alone amounts to more than £1.73 billion, which is equivalent to the annual cost of treating coronary heart disease. I also understand from the Department of Health's hospital episode statistics that fractures in patients aged 60 years or over account for 2 million hospital beds in England each year, which is more than for diabetes, heart failure and obstructive airways diseases.
	The timely diagnosis and prevention of osteoporosis is therefore a telling example of where the principle of spend to save applies. It applies both in cost terms to the NHS in the long term but, just as important, by helping to prevent people from suffering life-changing and life-worsening fractures and thereby allowing those people to retain a much better quality of life.
	There are three principal, interlinked ways in which the diagnosis and treatment of osteoporosis can be improved. They are all important if we are to get a properly integrated and effective national osteoporosis service. First, in relation to GPs, the quality and outcomes framework that rewards GPs and incentivises them financially to provide quality care in specific disease areas should be modified to include osteoporosis. I know that the National Osteoporosis Society has made a strong case for including clinical indicators for osteoporosis in the current review of the QOF and I hope that the Government will support this. It would ensure that a higher priority was given throughout the country to osteoporosis prevention and its treatment in GP practices.
	Secondly, there is the important issue of osteoporosis and the current guidance from the National Institute for Health and Clinical Excellence. I shall refer to two aspects of the NICE guidance. Perhaps the most pressing and the most timely issue from the point of view of this debate relates to the technology appraisal of drugs used in treating osteoporotic fractures. NICE issued its final appraisal determinations in this area on 26 June this year, but only this past Monday, 22 October, was an appeal against this heard. The outcome will be known shortly. Perhaps in her reply, the Minister can say precisely when this will be published. The guidance issued in June by NICE, which is mandatory, stipulates that the drug alendronate should be prescribed to women at high risk of osteoporotic fracture, but the appraisal fails to provide any alternative treatment for women—I understand that this applies to one in four women suffering from osteoporosis—for whom alendronate is unsuitable and for whom the side effects are unacceptable. It is not clear at the moment how such women will be treated and this is causing concern and confusion. Surely it is essential that such women are able to access effective alternative treatments on the NHS.
	The second aspect of NICE's work in relation to osteoporosis is the clinical guidelines process. I understand that a clinical guideline on osteoporosis is in development. Such a guideline would be important in highlighting the best ways of preventing and treating the disease, but at the moment we have no publication date. Again, I would be grateful for any further information that the Government can give us on this.
	Lastly, there is the important question of the National Service Framework for Older People. As noble Lords present will be aware, this was published in 2001 and included welcome guidelines on improving falls services and osteoporosis services in the NHS. The main problem, however, has been the slow pace of implementation. The Healthcare Commission audit published in March last year detailed the shortcomings in the organisation of falls services, particularly in hospital departments, including A&E.
	As far as primary care trusts are concerned, there is some good practice. I have heard of examples in surgeries where specialist practitioner nurses look through records and identify people at particular risk of osteoporosis and then offer them a consultation. I would like to see that good practice translated throughout the country. However, I am not convinced that the mechanisms for translating such good practice are currently very effective. Again, the fact that the department collects so little information on these practices centrally reinforces the difficulty of trying to get good practice translated on the widest possible scale.
	All the aspects that I have mentioned—effective implementation of the national service framework, better NICE guidance and the inclusion of osteoporosis in the quality and outcomes framework—are interlinked. Those three taken together would provide a package of measures that would greatly improve the situation and show a good way forward. However, the present situation is not satisfactory and so, in concluding my remarks today, I hope that the Minister in her reply will be able to assure the House not only that the Government are giving this issue the serious attention that it deserves but that the shortcomings that clearly exist at present will be properly and fully addressed in the near future.

Baroness Cumberlege: My Lords, I would like to thank the noble Baroness, Lady Quin, for securing this debate, for her clear exposition of the issues involved and for her prompt that I should mention that I am co-chair of the All-Party Parliamentary Group on Osteoporosis. I am delighted to see the noble Baroness, Lady Royall, on the Front Bench. I know that she is extremely sincere and hard working and tries to be well informed, but she covers three departments. I am disappointed that the health Minister has felt unable to come today to answer what I think is a very important debate. After all, he is responsible and accountable to this House and, with his fellow Secretary of State and Ministers, for taking steps to improve services for osteoporosis and shaping the Government's policy. I am sure that he is very diligent and will, in his busy life, read Hansard, but that is not quite the same thing as answering this debate. It is a very important debate because osteoporosis affects almost half of all women and one in five men over the age of 50 who will break a bone due to this distressing condition.
	In 1993, when I was a health Minister, in the country osteoporosis was rarely talked about. As part of my portfolio I was responsible for women's health. In an interview on ITV, I was asked what the Government of that day were doing about women's health. I mentioned breast and cervical cancers, and maternity. In a throwaway line I mentioned osteoporosis. I was astounded: in the next few weeks I was bombarded by women asking me exactly what the Government were doing about this disease, and I had to say that they were doing very little.
	So I set up an expert group under the chairmanship of Professor David Barlow to give advice on exactly how to take the issue forward. I asked the group to take a long, hard look at what was already known and to suggest what more could be done. In 1994, a year later, the group produced a comprehensive and a coherent programme directed at preventing, diagnosing and treating osteoporosis, and I was very grateful to it for its diligence.
	I welcomed the report and accepted its advice on four major elements: first, that bone scans should be available for women at high risk of developing osteoporosis; secondly, that guidelines for treatment should be prepared; thirdly, that further work should be done on preventive measures, such as dietary calcium and physical activity; and fourthly, that specific research should be undertaken.
	Much progress has been made in the intervening 13 years, a lot of which is due to the dedication of clinicians in the field; the National Osteoporosis Society—the noble Baroness mentioned that—and not least its patron, the Duchess of Cornwall; and women themselves. The network of 115 branches nationwide work hard not only to help themselves but also to give publicity to the condition and to raise funds for research. I have to say though that research is still wanting. There is a paucity and we need major funding to carry out a specific programme.
	Osteoporosis is often referred to as the silent epidemic, and it is, in that those who have it are unaware. With an increasingly elderly population, the numbers are growing. That is why it is so critical to raise awareness among not only the population as a whole but among GPs and other clinicians, so that it is diagnosed and actively managed before a break or a fracture occurs. About 20 per cent of those who suffer a hip fracture die within a year, if they do not die earlier from MRSA or C. difficile, while those who survive are no longer able to live independently. In 2000, in a survey of older women published in the BMJ, 80 per cent said that they would rather die than experience the reduced quality of life that follows a serious hip fracture.
	Vertebral fractures are typically under-diagnosed and under-treated, with only one-third of those evident on an X-ray brought to the attention of medics. Some 40 per cent of patients sustaining a clinical vertebrae fracture will be in constant pain and the majority will have difficulties with everyday activities. I should like to ask the noble Baroness, Lady Royall, to bring to the attention of the Minister the need to deliver better access to integrated osteoporosis services for men and women who are at risk. It is the necessity for GPs, rheumatologists, geriatricians, orthopaedic surgeons, obstetricians and clinicians working in emergency care not only to be aware so that they diagnose correctly, but also to act together so that information about a specific patient is shared and the patient properly treated.
	As the noble Baroness, Lady Quin, has mentioned, the National Institute for Health and Clinical Excellence is developing a clinical guideline on osteoporosis to help clinicians to identify and treat those individuals at highest risk of a fracture. But this work is ongoing and the report is not due for some time. The noble Lord, Lord Darzi, has a unique opportunity in the review of the NHS to address this issue and include it in his final report to be published in the spring of next year. I should like to ask the noble Baroness to put this suggestion to the Minister, as sadly he is not with us today.
	For some time, the All-Party Parliamentary Group on Osteoporosis has been campaigning to include osteoporosis indicators in the quality and outcomes framework, which was mentioned by the noble Baroness, Lady Quin. Those indicators should be in the GP's contract. The renegotiation of the contract is also under review. Again, it is an opportunity to incentivise GPs to take this condition seriously and think of osteoporosis when in consultation with patients. The inclusion of indicators would support the achievements of policy objectives in the four nations of the UK. Will the noble Baroness ensure that this suggestion is put to the ministerial team?
	Looking to the future, the population of 50 year-olds is expected to increase by 10 per cent by 2010 and by 25 per cent by 2020. By 2020, the number of osteoporotic fractures is set to increase annually by 21 per cent and the cost of treating people with hip fractures is expected to rise by 20 per cent at a cost of £20 billion per year. Those figures are based on the minimum costs of treating a single hip fracture, although recent evidence suggests that this figure could be up to three times higher than previously predicted, even without the cost of social care being included.
	The all-party group also campaigned to get falls into the National Service Framework for Older People. The framework is now half way through its allotted life of 10 years, yet healthcare providers are still failing to roll out the standards of care that it recommends. These failures are recognised in separate reports by the Royal College of Physicians and the national director for older people, Professor Ian Philp. We know that frameworks in themselves are not executive. It is the implementation of them which is so difficult. What levers do the noble Baroness and her colleagues have to ensure the national service framework is fully implemented? Finally, in the knowledge that a range of drug treatments exist to reduce the risks of patients suffering an osteoporotic fracture, some costing as little at 14p per day, does the noble Baroness agree that it is infinitely more cost effective to prevent than to treat, in which case can she suggest how this might be achieved and whether the PPRS system is a possible vehicle to do this?

Baroness Masham of Ilton: My Lords, I thank the noble Baroness, Lady Quin, for asking this important Question. If osteoporosis services are improved, not only will it help human suffering, it will also be cost effective to the National Health Service in the long run. It is most appropriate that the noble Baroness, Lady Royall of Blaisdon, is replying to this debate, because she understands the problems of osteoporosis. As she works so hard answering so many of your Lordships' health debates and Questions, would it not be possible to make the health Minister's position in your Lordships' House a shared one? The noble Lord, Lord Darzi—Professor Darzi—is working part-time so that he can continue his vocation as an important surgeon. Would this not be a solution to solve the concern of the noble Baroness, Lady Cumberlege?
	My aunt, my mother's sister, daughter of a doctor, developed osteoporosis in later life. She was such an uncomplaining person, but as she shrank she suffered many falls and fractures. When one sees this distressing situation, the need for prevention becomes obvious. I wonder whether, had she taken HRT, her osteoporosis would not have been so severe.
	Someone I know who lives in my home village of Masham and who was a theatre sister for years, with a very lively personality, is now wracked with arthritis and is very osteoporotic. She is in agony and implores the doctors to relieve her pain, which does not seem to be possible. Every time I see her, she has grown smaller.
	This is a condition which needs attention immediately, as we are an ageing population. The situation will only get worse unless it is tackled as a priority now. Almost half of all women and one in five men over the age of 50 will break a bone due to osteoporosis. These fractures, which occur most frequently in the hip, wrist or spine, have the potential to severely curtail a person's quality of life. And now, when they have to be admitted to hospital, they have the added worry of acquiring a dreaded hospital infection. Each year, fractures in patients aged over 60 years account for more than 2 million hospital bed days in England alone.
	The overall issue with the National Service Framework for Older People is a lack of implementation in relation to Standard 6, which concerns osteoporosis and the reduction of falls. Reports published over the past three years by the All-Party Parliamentary Group on Osteoporosis, by the Healthcare Commission and the National Clinical Director for Older People indicate a lack of progress in the development of a specialist falls service and integrated osteoporosis services as recommended in Standard 6 of the NSF. Despite the fact that the NSF is a mandatory 10-year national programme, the lack of uptake across the country has prevented any real improvements in osteoporosis services being achieved. Action must be taken to encourage PCTs to put the necessary standards in place as soon as possible. It will help to have a clinical guideline to assist clinicians in appropriately identifying and treating those individuals at highest risk of osteoporotic fractures, and a technology appraisal on the use of drugs to prevent primary and secondary fractures occurring in post-menopausal women.
	The General Medical Services Contract guides the practice of the vast majority of GPs working in the UK. A component of this contract is the Quality and Outcomes Framework, the QOF, which covers some, but not all, clinical conditions. Through measurement of clinical indicators resulting in the award of points from which payments to GPs are allocated, the QOF is a crucial driver of practice for the achievement of many national standards and implementation of guidance, including some areas of medicine that have been selected for inclusion. But no indicators for osteoporosis are included in the QOF, despite the importance of the primary care setting in the prevention of osteoporotic fractures. Consequently, unlike other chronic conditions that are manageable in primary care, such as heart disease, there are no incentives to treat osteoporosis.
	On Tuesday, I attended a very interesting health breakfast in another place on the subject of pain in women. We were told that pain in women could spread differently from pain in men. When research was being done on rats, only male rats were used. I asked why this was so and was told that female rats are more complicated, as is the pain in women. This could be a relevant matter in researching pain in women associated with osteoporosis. I hope that this matter will be looked at in the future.

Baroness Wilkins: My Lords, I am most grateful to my noble friend Lady Quin for having initiated this debate on a condition which does not receive the attention it deserves. While osteoporosis is mentioned in national policy, it tends to be side-lined and remains under-prioritised. I welcome the attention that is now being given to the needs of post-menopausal women, especially the one-in-four women who are not receptive to Alendronate—as my noble friend pointed out—the mandatory treatment recently approved by NICE. I should declare an interest as someone who broke a leg in a simple fall a few years ago and has been prescribed alendronic acid since then.
	I hope that, through the work of organisations such as the National Osteoporosis Society, we are beginning to see progress so that osteoporosis is no longer taken for granted as an accepted facet of ageing, but is seen as a serious condition which requires prevention and treatment. However, that attention seems to be focused solely on the older population. Today, I want to highlight the needs of a group at an even higher risk of osteoporosis than the post-menopausal, but who receive scant attention when it comes to prevention—those who are long-term physically disabled with conditions such as polio, rheumatoid arthritis and spinal cord injury. Again, I declare an interest.
	The fact is that osteoporosis is very common in the disabled community. Fractures can have a devastating effect on our lives, not only in social terms, but also in long-term unemployment. When I broke my leg, I became totally dependent for the three months while it healed, unable to leave the house and needing help with everything from getting into bed, going to the loo and having meals made. But it was hearing about the experience of Kamran Mallick, the director of my local disability organisation, which for me put this issue into very stark relief. He has given me permission to tell his story.
	Kamran is a 35 year-old wheelchair user who was paralysed by polio when he was two. When he was 16, he had metal rods inserted by the Royal National Orthopaedic Hospital to support his spine, but his curvature has now worsened and the bone is fighting against the metalwork. He is in constant, appalling pain because his ribs are grinding against his hip bones. He referred himself back to RNOH in 2002, and the back specialist said that he could do further surgery. However, in the mean time Kamran had, by pure chance, met someone doing research into the bone density of disabled sportsmen. Out of curiosity, Kamran checked out his own bone density and discovered that it was very poor. The consultant, when informed of this, refused to do the surgery until his bones were strengthened. Kamran now wonders whether anyone would have picked it up, had he not done so, and whether the operation would have resulted in potentially disastrous consequences. No one had ever alerted him to the danger that he was in from osteoporosis.
	Kamran has had regular bone-strengthening injections over the past four years, which have been pretty gruelling and ultimately not effective as his bone density constantly yo-yo's, going up and then down again. He is now in a desperate situation with the pain, and is only coping by spending every night and all weekend on traction in hospital, then coming into work each day. This is an appalling quality of life in anyone's book. His bone specialist consultant wants to prescribe Teriparatide, a drug which helps to regenerate bone. It can only be given for a maximum of two years and would cost £15,000 over that time, but at present it has only been cleared for women with osteoporosis over the age of 65. The consultant cannot prescribe it under the NHS unless the PCT will pay for it, and Barnet PCT is refusing to do so because of the cost. It could fund the drug, but is making use of the fact that it has not been cleared for younger people. Kamran has represented himself to the PCT panel twice on appeal, and has been refused. He is going for the final time in November.
	What sense is there to this short-term, wasteful, blinkered silo mentality to funding? The cost of this drug is hugely outweighed by the cost of not funding it—the huge personal cost to Kamran, who is in constant severe pain, spending every night and all weekend on traction in hospital. This drug is his only hope to improve his physical situation, otherwise he is faced with a future of having to give up work and be supported by the state, not only for his income, but also for his care.
	And what about that cost to the state, which he is trying to avoid? The state will be spending far more than £15,000 well within a year of him having to give up work, with escalating costs into the future. I declare an interest in the cost to HAFAD, Hammersmith and Fulham Action on Disability, the organisation of which he is director and I am the vice-chair. HAFAD is a sizeable local organisation of disabled people with a budget of approximately £800,000, about 20 staff, plus many volunteers. Kamran is an outstanding director who manages to fund and hold together a whole raft of projects, from welfare benefits advice to holiday youth schemes and support for direct payments, which help to provide equal opportunities for disabled people in the borough. He has established a thriving employment project, helping disabled people back to work, and is striving to turn the organisation into a social enterprise so that it can be self-financing— everything that the Government are aiming for in national policy for disabled people. But much of that would collapse if he was forced to give up.
	Kamran's experience shows the waste and tragedy that can result from fragmented services. Nowhere in the system is there recognition of what he contributes to society. Within the NHS, there has been no one who has treated his needs as a whole. As a result, since he had not seen his back specialist for over a year while he was getting the bone treatment, he then had to return to the bottom of the waiting list when he was re-referred for surgery, all adding to his frustration, pain and distress.
	Surely this is a glaring example of the need for the Independent Living Bill championed by my noble friend Lord Ashley of Stoke, which was passed by your Lordships' House but which has now fallen in the other place. His Bill would ensure that health and social services work together and pool their budgets so that the funding is used to provide the service which disabled people both want and need, and not wasted in this bureaucratic minefield.
	Most importantly, Kamran's bone density condition should never have reached this severe state. Why was preventive action not taken years ago? Why was it that it was only his curiosity which led him and his surgeon to know that his bones were crumbling? It is accepted that there are a number of long-term conditions which put people at a higher risk of osteoporosis—I have mentioned only three—so I ask my noble friend the Minister whether the Government will take urgent steps to raise awareness of the need for preventive treatment for osteoporosis, both among the medical profession and the disabled community? With government policy emphasising the need for people to take responsibility for their own health, it is essential that disabled people are made aware of the potential risks.
	I am advised by Mr Fadel Derry, a spinal cord injury consultant at Stoke Mandeville Hospital, that osteoporosis is so common among spinal cord injured people that the use of bone density scans is actually academic and a waste of resources. In his view, it would be far more cost effective if the funding for prevention was channelled into the provision of standing frames and standing wheelchairs, which have other benefits as well. Would my noble friend give her support to this?
	Furthermore, it is clear that too little is known about the effect of drugs in preventing osteoporosis among long-term paralysed people. Would the Government support research into both primary and secondary prevention in spinal cord injury and polio using biphosphonates to produce evidence of the effectiveness of the long-term use of these drugs? Would the Government also encourage NICE to include at least one spinal cord injury specialist in drafting the guidance on preventive drugs?
	Considerable improvement also needs to take place within the NHS in the treatment of long-term paralysed people once they have sustained a fracture. GPs, accident and emergency teams and orthopaedic surgeons are not sufficiently aware that the treatment of a long-bone fracture in someone who is paralysed often needs to be quite different from treatment given to a non-paralysed person with osteoporosis, otherwise severe complications will arise—for example, there is considerable ignorance of the danger of pressure sores while the bone is in plaster. The pressure on specialist centres such as spinal cord injury centres as a result of these failures in treatment is considerable.
	I am extremely grateful to my noble friend Lady Quin for having raised this important topic. I hope that it will lead to much greater attention being paid to all the groups who are at high risk of osteoporosis, not only post-menopausal women.

Lord Addington: My Lords, as a man, I find myself in a minority group in this debate. That is a reversal of the usual balance between the sexes in this House. That brings me to the point that we do not consider men to be a stereotypical group of those who have problems with osteoporosis. As the noble Baroness, Lady Wilkins, has just pointed out, one of the stereotypical groups is that of elderly woman. Many people probably do not know that men can suffer from osteoporosis.
	One of the reasons why women are more susceptible to this condition is that they live longer and any other progressive condition may not manifest itself to the same degree. The fact that men have larger, thicker and denser bones than women also makes them less susceptible to the condition. However, the condition can be very damaging to men. If we are to achieve a greater equality in health for men, we shall have to address this problem, first and foremost by creating a greater awareness among the male population and healthcare professionals.
	One of the themes running through the debate is that we are not paying enough attention to creating preventive methods and not raising awareness among medical practitioners and those who may suffer from the condition. The NHS is better at dealing with acute problems as they are presented than it is at creating long-term strategies for preventive healthcare. This applies not only to the NHS; it runs across the entire framework of government. We are much better at dealing with problems as they occur than at preventing them. We are also much worse at investing in prevention than we are at investing in a problem once it is presented.
	The usual way in which we deal with such a problem, once we are aware of it, is to wait until it becomes acute; then there is a degree of pressure and there is a reaction. As the noble Baroness, Lady Wilkins, said, a series of case studies is brought forward, people then think about the problem and then we go back. The whole governmental structure in Whitehall tends to react in this way. It is our responsibility, and particularly the responsibility of whoever is in power, to address this problem and to get in early.
	As we heard from the speech of the noble Baroness, Lady Wilkins—to which I can relate strongly from my experience with my previous portfolio—government departments tend not to support one another. The ongoing costs of not addressing this problem in the disabled community means that much of the Government's drive towards getting people off benefits and into work may well be wasted. If we do not get departments to live up to their duties and make sure that they know that one group is more likely to suffer from osteoporosis than another, it does not matter how many interviews you have at various job centres or restart projects—call them what you like—you will still fail to bring in the money. I totally agree with the points made about the legislation that the noble Lord, Lord Ashley, has been championing. Unless we talk to one another across the silos, we will miss our targets.
	We must ensure that the NHS decides what NICE is going to do and decides that NICE gives higher priority to preventive care. If we are to carry on with NICE, there is a case for us in Parliament to become the ultimate stage for appeals on its decisions, as opposed to saying that someone should give it better criteria to work to. We must ensure that we intervene more clearly and that on-costs are taken into account by other departments, otherwise we will always come back to saying, "If only we'd intervened quicker; with all the expertise going around, we could have done something else".
	To return to the under-represented male group, what do we actually know? The research that I did for this debate from the information provided for me pointed out that the male menopause is, as I am assured by most females, a reality, although not a medical reality, because we do not have the huge chemical change in our bodies. However, we produce less testosterone, the preventive and supportive hormone; the level of help and prevention that it provides reduces over time. That is what leads to this problem. The symptoms of wanting to buy motorbikes and fast cars as we hit the age of 45—I have about a year to go—may be psychological, but the fact is that we are suffering many of the same problems as women, although we have them at a slightly slower rate. Will the Government do some work to find out what is the safe, normal level of testosterone? What sort of supportive care can we offer at the moment?
	What are we doing to make people aware of the diagnosis of osteoporosis in men? If you have a comparatively light fall and you break a bone, and you are male, what training is given to medical professionals to decide whether you should then be tested for osteoporosis? What is the guidance? Are we taking this seriously? Do people know that signs of height loss, for instance, can be seen as a sign of the condition? Is this being taken as seriously for the male of the species as it is for the female? Are we addressing height loss and testosterone level testing seriously? Are all these packages being brought together and presented as something that doctors should know about? If we are successful in the testing, the benefits will roll out. If we manage to keep the average man living almost as long as the average woman, these problems will become more acute.
	I look forward to hearing the Minister's reply, but I would appreciate having some guidance given to us about where we are fitting the structure of preventive healthcare into our overall planning and what safeguards we have that any budget put forward cannot be raided the next time we have a cash-flow problem.

Earl Howe: My Lords, it is extraordinary that this is the first time in over 10 years—I have checked this—that the House has had a full-scale debate on this extremely important subject, so the noble Baroness should be congratulated doubly for having tabled her Question. She was, of course, right in all that she said. The messages are stark: brittle bones and bone fractures are the source of immense amounts of pain and distress among older people, and the cost to the NHS and to the country is commensurately huge and rising. The combined cost of hospital and social care for patients with osteoporotic fractures is reported as being more than £1.8 billion a year, a figure that the noble Baroness mentioned. One in two women and one in five men is likely to suffer such a fracture after the age of 50. Out of every five orthopaedic beds, one is occupied by someone who has had a hip fracture. Twenty per cent of those patients die within a year as a consequence; another 20 per cent end up in a nursing home. In fact, the suffering that arises from a fall and a hip fracture in old age cannot really be measured. So great is the dread of immobility arising from a serious hip fracture that, as my noble friend mentioned, over 80 per cent of older women said in a survey that they would rather be dead than experience the reduced quality of life that that would bring.
	As with so many issues in the public health arena, we know what we should be doing about all this but the evidence, unfortunately, is that we are just not doing it. There have been improvements in NHS provision over the years; we have the NSF for Older People, and we have recognised preventive treatments. But as the British Orthopaedic Society reported last month, most eligible patients miss out. A recent UK audit showed that fewer than 5 per cent of women with a history of fracture underwent a DEXA scan for bone density, and fewer than 10 per cent were treated with drugs to reduce the risk of further fractures. The sobering part is that we know it is possible to predict a great many of the hip fractures that occur in the elderly, and therefore to prevent them. The biggest predictor is a fracture that has happened to someone previously. In fact as many as half to two-thirds of patients who present with a hip fracture have broken a bone before. The unpleasant conclusion is that many people at risk are not being looked after properly by their doctors.
	That brings us to the whole question of the quality and outcomes framework. GPs are perfectly placed to be targeting those patients at risk of brittle bone fractures, but all the evidence is that this kind of proactive, preventive doctoring is not happening nearly enough. Doctors are well aware that there is a range of a priori risk factors for osteoporosis: being white and female; having had an early menopause; having a low body mass index; being a smoker or a drinker; leading a sedentary lifestyle; being on steroids—all these are predisposing factors. The QOF provided a golden opportunity to bring uniformity to the way in which fragile bone disease is targeted throughout the country, but the opportunity was not seized. It would be very helpful if the Minister could bring us up to date on this. What representations have been received on the subject by her department, and is she aware of any plans for osteoporosis to be included in the framework in future?
	Part of the problem, so I understand, is that many of the signs or symptoms that might otherwise sound the necessary warning bells are not always recorded. For example, the fact that someone has been on a long-term course of steroids is very seldom flagged up on computer recordings, and older patients who have had a history of falls are very unlikely to have that fact recorded. The same applies to the investigations associated with a previous fracture: the patient record often does not highlight them. One of the main conclusions from the report published in the summer by QResearch was that computer recording of diagnoses of osteoporosis needs to be improved so that patients at risk of fracture can be more easily identified. There needs to be better recording of the interventions and treatments delivered to those at risk. In particular, there need to be much better systems in place to prevent bone fractures among older people living in residential care homes, where it was found that only one-third of such people are receiving the very basic and extremely cheap therapy of extra calcium and vitamin D. So there are a number of very simple indicators, which the QOF could include, that would make a huge difference to the burden on secondary care arising from bone fractures and an equal difference to the workload of falls services.
	Falls services are extremely important. A couple of years ago, the Royal College of Physicians discovered in an audit exercise that, although about three-quarters of trusts in England are part of a co-ordinated falls service, there were key parts of hospitals, such as A&E and fracture units, where falls and bone health are not adequately addressed. The amount of actual clinical activity in these areas was surprisingly low, and it was noticeable that public health strategies often failed to make mention of either falls or bone health. Part of the problem that the Royal College identified was that trusts found it difficult to get the necessary information from PCTs relating to either issue. It would be useful if the Minister were able to tell us whether things have improved over the past two years since the royal college audit was done. The gold standard nowadays is for every trust to be part of an integrated, multi-agency, multi-professional service for falls; and that a quarter of trusts should not be is clearly unacceptable.
	The noble Baroness, Lady Quin, rightly referred to the guidance published by NICE. I have spoken to two doctors about this, who both echoed the concerns that have been expressed recently by the National Osteoporosis Society and the Nuffield Department of Orthopaedic Surgery, among others. A decision to rule out NHS funding for all but one of the generic first-line treatments will leave doctors without any ability to exercise their clinical judgment to prescribe something else, if the patient cannot tolerate that particular treatment. Alendronate is known to cause nasty side effects, which some patients find intolerable. I do not as a rule criticise NICE's decision-making, because it is an organisation of which I approve, but I very much hope that it will listen to the representations made to it on this subject and that it does not leave doctors in a position in which they can choose from a menu of only one.
	Prevention is one part of this equation and treatment is the other part. I was encouraged to see that a new audit is currently under way to improve the care of patients who have suffered hip fractures. The aim of this is to audit hospitals against six standards that are set out in a guide to best practice published by the British Orthopaedic Association and the British Geriatrics Society. The two key standards are that patients with hip fractures should be admitted to an acute orthopaedic ward within four hours of presentation and that surgery should be performed within 48 hours on all those who are medically fit. Some 75,000 people every year break a hip. Sadly, the evidence is that at least half those people wait more than 48 hours for an operation; and a delay beyond that period means that you are more likely to die or suffer permanent disability. I very much hope that this audit process will lead to faster response times and a general raising of standards.
	The Minister has been given a lot of food for thought in this debate—at least I hope so. She will need no convincing of how important it is that we tackle this awful condition in a systematic and co-ordinated way across the country. The good news is that it is well within our capability to do it. All we need are the systems, the incentives and, of course, the will.

Baroness Royall of Blaisdon: My Lords, this has been an excellent and long-awaited debate and I thank my noble friend Lady Quin for enabling it to take place. I am grateful to all noble Lords who have spoken, and I am especially grateful to the noble Baroness, Lady Cumberlege, not only for her expertise but for being the catalyst in many ways of some of the pioneering work that has taken place over the past few years.
	My noble friend spoke eloquently about osteoporosis and the devastating effect that it can have on people living with the condition, their families and those who care for them. Here I must declare an interest in that my mother had chronic osteoporosis before the wonderful new drugs had been developed. She was a wonderful, gentle, long-suffering woman who shrank swiftly. In the end, after years of suffering, she fell out of bed in hospital, broke her hip and died in a month—because, basically, she did not want to live. She did not want to be immobile with a broken hip. I, too, have low bone density, so I have a vested interest in all this and am acutely aware of the problems. I am a proud member of the National Osteoporosis Society and thank it for its brilliant work in raising awareness, raising money for research and providing invaluable advice and support to those who suffer from osteoporosis.
	While osteoporosis affects some younger people, together with falls it has important implications for the older population and we recognise that they represent a significant and growing burden on our health and social care system. Just this week we learnt that there are now more pensioners than children in this country, and we all want to remain as healthy and independent for as long as possible. I thank the noble Lord, Lord Addington, for raising awareness of the often-overlooked fact that men as well as women suffer from osteoporosis.
	In 2001, the Government published the National Service Framework for Older People, the first ever comprehensive strategy to ensure fair, high quality, integrated health and social care services for older people. Among other things, it highlights the importance of services for key conditions, including osteoporosis, and acknowledges that falls are a major cause of disability, and the leading cause of mortality resulting from injury, in people aged over 75. Osteoporosis is closely linked with falls prevention, as the risk of fracture after a fall increases with age. Prevention and effective management of osteoporosis has a significant effect on both the numbers and the social and economic cost of fractures. The development of integrated falls services was a key objective of the NSF and support for the local development of those services has been provided through guidance published by the Department of Health and through a co-ordinated approach with other national organisations with an interest.
	The noble Baroness, Lady Masham of Ilton, referred to Standard 6 of the NSF. There is a lot more to be done to ensure that Standard 6 is being respected throughout; however, I draw the noble Baroness's attention to a national audit of falls services for older people, which was undertaken by the Royal College of Physicians in January 2006, which confirmed that 74 per cent of trusts had part of a co-ordinated, integrated, multi-agency service for falls. Overall, the audit results suggested that most areas have the infrastructure with the potential to identify need and provision of specialist fall assessment and treatment. That is not enough but we are getting there. There are many innovative and effective projects around falls up and down the country. For example, in the north-east the ambulance service works in partnership with local councils, using computer programmes to identify "fall hotspots" such as uneven pavements or ungritted paths in winter in areas with a high concentration of older people. Such schemes should be commended.
	The National Director for Older People's report, A Recipe for Care, highlights that a modest investment by the NHS in developing falls and bone health services in line with NICE guidelines would produce significant benefits in reduced mortality, increased quality of life and savings through a reduction in hospital admissions—spend to save, as my noble friend said. We know what needs to be done. The policies are there but we have to ensure that they are translated into firm action by the NHS and councils. Local commissioners must decide how these things can be achieved but the Department of Health has a role in improving the way in which this commissioning is undertaken.
	I am, of course, aware that Falling Short, the APPG report on osteoporosis services, recommended the inclusion of osteoporosis in the Quality and Outcomes Framework—something of which many Lords have spoken. Clearly there is good evidence for the efficacy of multi-professional falls interventions in reducing the risk of a fall and osteoporotic fracture. Work in other clinical areas such as coronary heart disease, asthma and diabetes has shown that both the quality of data recording and the level of care for these conditions can be greatly improved by incorporation in the Quality and Outcomes Framework.
	The QOF is part of the General Medical Services Contract. It is a voluntary incentive scheme that rewards practices for achieving quality indicators across a wide range of clinical and organisational areas. It is a "living" document that is subject to a process of change and improvement over time. Recommendations on priorities for new areas in QOF, for negotiations regarding the 2008-09 contract, are being considered at the moment but it would not be appropriate for me to comment or to speculate. However, if osteoporosis is not included in 2008-09, we will certainly consider including it in QOF for 2009-10, and I will follow that up. However, in the mean time I am sure that much more could and should be done to raise awareness of osteoporosis among GPs to ensure that they see the telltale signs, diagnose accordingly and that the correct treatment can be prescribed. I note the point made by the noble Lord, Lord Addington, that men especially should have their awareness raised because so many GPs are not aware that this affects men as well as women. In the 21st century there is no reason why it should be undiagnosed in primary care.
	I will write to the Chief Medical Officer suggesting that he should draw GPs' attention to osteoporosis in one of his forthcoming CMO updates. We must do more to raise awareness and diagnosis especially for people with long-term disabilities. I am very grateful to my noble friend Lady Wilkins for drawing our attention to that. I will, of course, draw it to the attention of my colleagues in the ministerial team. Kamran is clearly an extraordinary young man who is suffering from a fragmented system—the sort of system that the noble Baroness, Lady Cumberlege, rightly spoke of—and needs better access to integrated services for osteoporosis. I am sure that that is one of the things that my noble friend Lord Darzi will look at in his review.
	The noble Earl referred to the QResearch and the fact that patient computer records need to be improved. This is something that the Department of Health is looking at and I will come back to the noble Earl in due course. He also highlighted the importance of a better flow of information from primary care to acute care and between local authorities and the health service. That again is something that my noble friend Lord Darzi will look at, although, of course, his review cannot be a panacea.
	As many have said, DEXA scanners are vital in identifying those at high risk of developing osteoporosis, enabling the appropriate advice and treatment to be given so that the number and severity of fractures can be reduced. DEXA scanning has long been regarded as the gold standard procedure in determining whether treatment is appropriate. In 2005, the department announced that a cash injection of £20 million would be invested into bone density scanning to improve access to DEXA scanning and reduce waiting times. An initial £3 million was allocated to those areas with longest waits for the purchase from the independent sector of additional scans in 2005-06. A further £17 million has been allocated to SHAs as strategic capital for 2006-07 and 2007-08 to improve NHS capacity through investment in new DEXA scanning equipment. I note the concern about the patchy availability of DEXA scanners and I do understand that because the additional investment is not ring-fenced, it could potentially be used for a purpose for which it was not intended. But the reduction in waiting times clearly demonstrates that there are now many more DEXA scanners. Since January 2006, the Department of Health has been collecting waiting time and activity data for 15 diagnostic tests or procedures, including DEXA scans.
	The latest data show that the number of patients waiting more than 26 weeks—which is outrageous—for a DEXA scan has been cut from nearly 4,000 to just 61. Only 800 patients are now waiting more than 13 weeks for a scan, which is down from nearly 9,500, and the total number of patients waiting for a DEXA scan is down by nearly a third. That is all very good news, but more needs to be done. For example, at a local level we need to ensure that scanners are working to maximum capacity. I am sure that most people would not mind if their scan was outside the 9-to-5 "normal" time for scanning.
	NICE guidance and its recent appraisal have been a key focus of this debate. The National Institute for Health and Clinical Excellence has been carrying out two technology appraisals on a number of treatments for the primary and secondary prevention of osteoporotic fragility fractures in post-menopausal women. The treatments that have been appraised are alendronate, etidronate, risedronate, raloxifene and strontium ranelate for both the primary and secondary prevention of osteoporotic fragility fractures. Teriparatide has also been appraised in the secondary prevention of osteoporotic fragility fractures. As noble Lords have said, NICE's recommendations on those drugs are the subject of an appeal and the outcome will be announced in due course. I am afraid that I do not have the date at present, but as soon as NICE informs the Department of Health, I will inform noble Lords.
	I could speak about NICE at length, but I am running out of time. I well understand the concern expressed, especially about those people who may have some adverse reaction to alendronate. I cannot make detailed comments, and I certainly would not wish to undermine the excellent NICE guidance in any way. I simply note the current clinical practice whereby patients who are unable to take one drug are offered another. I cannot see that situation changing.
	Through the Musculoskeletal Services Framework, we have also taken steps to improve assessment, diagnosis and treatment for osteoporosis and other musculoskeletal conditions in England. The goal is to ensure better outcomes for patients through a more actively managed patient pathway, with explicit sharing of responsibility agreed between all stakeholders; all health and social care clinicians and managers, the voluntary and community sector, patients and the public.
	Notwithstanding the many real concerns that have been expressed today, the initiatives that I have described clearly demonstrate that the Government are doing much to support NHS organisations to improve osteoporosis services. There is greater awareness, better diagnosis, waiting time for scanning is at a record low and more services are now in place for older people who have fallen. We are also doing much on the preventive front, with general lifestyle messages around diet, exercise, reducing smoking and avoiding excessive consumption of alcohol, which are all important in the prevention of osteoporosis.
	I do not underestimate how disabling, painful and debilitating this silent epidemic is for those who suffer, or the impact on their families, or the impact on health and social care services. I am confident that real advances have been made and will continue to be made. I assure noble Lords that the Government are absolutely determined to support the development of good services.

London Local Authorities and Transport for London Bill

A message was brought from the Commons that they have considered the Lords message of 22 October and have made the following order:
	That the promoters of the London Local Authorities and Transport for London Bill, which was originally introduced in the Commons on 25 January 2005, should have leave to suspend any further proceedings on the Bill in order to proceed with it, if they think fit, in the next Session of Parliament, according to the provisions of Private Business Standing Order 188A (Suspension of Bills).

Local Government and Public Involvement in Health Bill

The Bill was returned from the Commons with the amendments agreed to.
	House adjourned at 3.27 pm.
	Correction
	The text of the first Oral Question in yesterday's Official Report was incomplete. The following text of the supplementary Questions and Answers will appear in columns 1071 and 1072 in the Bound Volume and on the internet.

Baroness Miller of Hendon: My Lords, I thank the Minister for that Answer. Having said that, I was worried at first that I had the wrong supplementary. I was going to ask whether he remembered the Consumer Credit Act 2006, but of course he was not in the House at the time we debated it. Is the Minister aware—I am sure that he is—that I proposed a very modest amendment that would have required the lender to ask the borrower if he had the means to meet the commitment? The then Minister replied that it was certainly not necessary to have that on the face of the Bill. Given the indebtedness of individuals throughout the country and the fact that I never like to say I was right—nevertheless I am going to say that I was right—could the Minister please now tell the House what they are prepared to do to remedy the situation?

Lord Jones of Birmingham: My Lords, I am grateful to the noble Baroness for indulging me and apologise for my incompetence at the beginning of my Answer. The Consumer Credit Act 2006 does contain important new safeguards for consumers. In particular, it will make it easier for the Office of Fair Trading to take action against lenders who do not take a responsible attitude to lending when considering who is fit to hold a consumer credit licence. But it is not just about addressing behaviour through legislation. Financial education, particularly of the young, has an equally important role in ensuring that a responsible attitude is taken to borrowing as well as lending.

Baroness Kingsmill: My Lords, is the Minister aware that 80 per cent of the debt in the UK is in the form of a mortgage, which is asset-backed, and that we have one of the most efficient financial services industries in the world? I declare an interest as a senior adviser to the Royal Bank of Scotland. Is he also aware that it is not in the interests of any financial institution to lend money to those who are unable to repay?

Lord Jones of Birmingham: My Lords, I am grateful to my noble friend for those remarks, which are helpful in providing a context to the debate. The vast majority of consumers are able to manage their debts well and the Government do not propose to interfere in those circumstances.

Lord Razzall: My Lords, does the Minister accept that the Government have been complacent on this?

Lord Jones of Birmingham: My Lords, much is being done: we have reformed the regulations governing consumer credit advertising to make these clearer and fairer. We have also introduced pre-contract information to help consumers to make an informed choice before entering into a credit agreement. The implementation of the Consumer Credit Act 2006 will give increased powers to the Office of Fair Trading to safeguard the interests of consumers. Beyond that, £11.5 million is being spent on a package of support for schools to teach children financial skills.

Lord Davies of Coity: My Lords, the issue of irresponsible lending has been widely canvassed. My concern is that the victims are the ones whose homes are repossessed. Does the Minister believe that the penalties for irresponsible lending are sufficient?

Lord Jones of Birmingham: My Lords, my noble friend is referring to two kinds of lending, one where there is security involved and one where there is no security. On the latter, I referred to action the OFT might take against irresponsible lenders in an earlier answer. As far as mortgages are concerned, the FSA has been doing a lot of work in this area recently. It recently published details of a review into the behaviour of intermediaries and lenders within the sub-prime mortgage market. It discovered weaknesses in responsible lending practices and in firms' assessments of consumers' ability to afford a mortgage. As a result it referred five firms to its enforcement division. Potential remedies include withdrawal of their permission to operate and financial penalties.